Reumatoid arthritis, polymyalgia rheumatica, psoriatic arthritis
Conditions
Interventions
Patients will be randomized to initiate a 4-day course of low dose GC therapy either via the oral or the parenteral route, and then cross over to 4 days via the other route. Before starting this proof
Sponsors
VUmc
Eligibility
Inclusion criteria
Inclusion criteria: -Reumatoid arthritis, polymyalgia rheumatica or psoriatic arthritis according to the treating physician -Elevated ESR (=30 mm/h)
Exclusion criteria
Exclusion criteria: Difficult to measure a decreased ESR -Current or recent (<4 weeks previously) on any form of GC therapy -For reumatoid arthritis and psoriatic arthritis patients, change of antirheumatic medication (DMARDs, biologics) in the 4 weeks before the assessment -Known with other health conditions that can cause elevated ESR (e.g. hematologic disorders, infections, multiple myeloma, monoclonal gammopathy etc.) Risk of harm -Active disease necessitating (change of) treatment within weeks, according to treating physician -Unstable medical condition causing contra-indication for GC, according to treating physician. For example active infection, unstable diabetes, malignant hypertension, etc. -Signs or symptoms of temporal arteritis (according to the treating physician)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| ESR | — |
Secondary
| Measure | Time frame |
|---|---|
| C-reactive protein (CRP), cortisol, adrenocorticotropic hormone (ACTH) and disease activity (based on Rapid3 questionnaire). Stored serum samples may be used for further analysis of inflammatory cytokines as exploratory endpoints. | — |
Contacts
Public ContactLinda Hartman
VUmc
Outcome results
None listed