GLORIA Study - Is Prednisone Harmful in Elder RA? Save

The GLORIA study (ABST# 1678) was a pragmatic, blinded placebo-controlled randomized trial from Dr. Martin Boers and colleagues where they assessed whether prednisolone (vs. placebo) use would alter clinical outcomes over 2 years.

A total of 451 elder patients with established RA received doctor prescribed optimum standard of care (DMARDs or biologics) but were randomized to receive either PBO or Pred 5 mg/day. DMARD changes were allowed but steroid changes were not. 

After 2 years, the steroid treated older patients had less disease activity and less radiographic progression. The downside was there were more nonserious infections with steroid use.  The NNH was 9.5 for modest adverse events. 

While the authors of the research believe that chronic low dose Pred has a favorable balance of benefit to harm, Dr. Richard Conway (see video below) believes not. Check out his video report on the GLORIA study.

This research is timely as there were many abstracts at ACR21 on the safety of infection, including CV and infection risk at Pred doses of 5 mg or less.