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Pulse Methylprednisolone in Rheumatoid Arthritis: A Double-Blind Cross-Over Trial

MICHAEL R. LIEBLING, M.D.; EDWARD LEIB, M.D.; KEVIN MCLAUGHLIN, M.D.; KENNETH BLOCKA, M.D.; DANIEL E. FURST, M.D.; KENNETH NYMAN, M.D.; and HAROLD E. PAULUS, M.D.
[+] Article and Author Information

▸Requests for reprints should be addressed to Michael R. Liebling, M.D.; UCLA Rehabilitation Center, 1000 Veteran Avenue; Los Angeles, CA 90024.


Los Angeles, California


© 1981 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1981;94(1):21-26. doi:10.7326/0003-4819-94-1-21
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Ten patients with rheumatoid arthritis unresponsive to conventional therapy participated in a double-blind cross-over trial in which they randomly received either a "pulse" of 1 g of methylprednisolone or placebo, intravenously, once a month for 6 months. Both the drug-first and placebo-first groups had the same mean American Rheumatism Association functional classification, 2.5. During the study patients on methylprednisolone "pulses," compared to placebo, showed significantly better mean tender-joint counts, walking times, and grip strength (p < 0.05). The drug-treated patients also had significantly lower levels of immune complexes (p < 0.01) and IgG (p < 0.01). Effects could still be measured an average of 2.9 ± 0.4 months after the last dose of methylprednisolone. No significant side effects were noted during the therapy. Despite these findings, "pulse" methylprednisolone did not appear to significantly retard radiologic progression of the arthritis.

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