Use of steroid and nonsteroidal anti-inflammatories in the treatment of rheumatoid arthritis

Abstract

BackgroundRheumatoid arthritis affects 1% of the world's population and its current treatment options are costly. There are not enough studies that evaluated the efficacy and safety of anti-inflammatory drugs medications used to reduce rheumatoid arthritis's symptoms. This study will evaluate the effectiveness and the safety of steroid and nonsteroidal anti-inflammatory drugs for the treatment of patients with rheumatoid arthritis.MethodsRandomized clinical trials eligible for our systematic review will enroll adults with rheumatoid arthritis treated with anti-inflammatory drugs compared with a control group (placebo or active control) at any dose, duration, and route of administration and double blind studies. In order to include all forms of rheumatoid arthritis and anti-inflammatory drugs, we will search the following electronic databases: Cochrane Central Register of Controlled Trials, MEDLINE (via Ovid); ExcerptaMedica Database (via Ovid); Cumulative Index to Nursing and Allied Health Literature (via Ovid); Web of Science; ClinicalTrial.gov; and WHO International Clinical Trials Registry Platform. We will not impose any language restrictions or publication status. Outcomes of interest include are pain, physical function, swelling, stiffness, grip force, radiological image of the joint, quality of life, adverse events, discontinuation due to adverse events, satisfaction with the treatment, and rescue medication for pain. A team of reviewers will independently screen search results, extract data from eligible trials, and assess risk of bias. We will use the Grading of Recommendations Assessment, Development and Evaluation approach to rate overall certainty of the evidence by outcome. Dichotomous data will be summarized as risk ratios; continuous data will be given as standard average differences with 95% confidence intervals.ResultsThe evidence derived by this study will increase awareness of the effectiveness and safety of steroid and nonsteroidal anti-inflammatory drugs for the treatment of rheumatoid arthritis.ConclusionThe results could guide patients and healthcare practitioners and help facilitate evidence-based shared care decision making.

Dexamethasone and diclofenac intramuscular mixture injection and risk of death: A case series study

“…SAIDs inhibit the release of arachidonic acid, the precursor of prostaglandins, whereas NSAIDs inhibit the cyclooxygenase‐1 or cyclooxygenase‐2 (COX‐ 1 or COX‐ 2) enzyme. Both classes have proven a high efficacy in relieving pain, reducing inflammation, and fever 3 . Anti‐inflammatory medications are associated with adverse reactions including hematobiochemical and immunological changes, and cardiovascular and gastrointestinal adverse effects 4 .…”

A survey of patients’ perspectives of steroid injection (ppyeojusa) in Korea

“…The most commonly used corticosteroids are triamcinolone acetonide, methylprednisolone acetate, betamethasone acetate and disodium phosphate, as well as dexamethasone [11]. Such steroids are used for various conditions, such as asthma [3], atopy, dermatitis [12], rheumatism [2], allergies and cancers [13], as well as pain. Since the indications and effects of steroids are very broad, steroids may be misused.…”

“…However, steroids are commonly used as a therapeutic agent in various fields, such as for skin diseases, skin depigmentation and atopy [1]; rheumatic conditions [2]; allergies; and respiratory diseases such as asthma [3] because of their anti-inflammatory and anti-proliferative effects. Due to the broad indications of steroids, they have been prescribed frequently and without strict criteria, resulting in various side effects, such as skin discoloration, Cushing syndrome, osteoporosis, and immunosuppression, especially with long-term use [4].…”

Can Ultrasound Therapy Be an Environmental-Friendly Alternative to Non-Steroidal Anti-Inflammatory Drugs in Knee Osteoarthritis Treatment?

“…The numerous prescriptions for patients with rheumatoid arthritis [ 16 ], ankylosing spondylitis [ 17 ], cancer pain [ 18 ], or infectious febrile syndromes [ 19 ], as well as those for veterinary pathology, where joint pain and functional limitations benefit also from NSAIDs treatment [ 20 , 21 , 22 ], are added to the prescriptions of NSAIDs for OA patients.…”