TOPLINE

Patients with early rheumatoid arthritis (RA) who used parenteral glucocorticoid (GC) injections (intramuscular or intra-articular) were less likely to remain on GCs after 1 year than those who used oral GCs, while disease control did not differ.

METHODOLOGY

• Researchers analyzed real-world data from a Canadian cohort of patients with early RA (CATCH) to assess whether the route of GC treatment (oral vs parenteral) affected ongoing steroid use or escalation to advanced therapy at 6 and 12 months.
• They included 2222 adults (mean age, 53-59 years; 53%-75% women) with newly diagnosed early RA (symptom duration < 1 year) between January 2007 and October 2023.
• Patients with GC use 90 days before baseline, those who received advanced therapy within 3 months, or those with less than 12 months of follow-up were excluded.
• Patients were grouped based on the route of GC use during the first 3 months: those with no GC use (75%), those using oral GCs (19%), those using parenteral GCs administered either intramuscularly or intra-articularly (5%), or those using both oral and parenteral GCs (1%).
• Researchers evaluated the proportion of patients remaining on GCs at 6 and 12 months, the proportion initiating advanced therapies, and measures of disease activity.

TAKEAWAY

• At 12 months, 26% of patients who received parenteral GCs in the first 3 months remained on GCs, whereas 47% of those who received oral GCs and 63% of those who received both oral and parenteral GCs remained on GCs.
• The odds of continued use at 12 months were higher among patients who used oral GCs (adjusted odds ratio [aOR], 9.8; 95% CI, 7.3-13.1) and those who used parenteral GCs (aOR, 4.1; 95% CI, 2.6-6.5) than among patients who received no GCs. 
• Users of parenteral GCs were 60% less likely to remain on GCs at 12 months compared with users of oral GCs (aOR, 0.4; 95% CI, 0.3-0.7).
• Decrease in disease activity at 12 months did not differ significantly between the groups. The use of oral or parenteral GCs was associated with a higher likelihood of escalation to advanced therapy than no use of GC at 12 months.

IN PRACTICE

"[The] findings highlight the potential role of parenteral GC as an effective and practical bridging strategy in early RA management," the authors of the study wrote.

SOURCE

The study was led by Andreu Fernández-Codina, Western University in London, Ontario, Canada. It was published online on August 28, 2026, in Annals of the Rheumatic Diseases.

LIMITATIONS

Researchers could not differentiate between intra-articular and intramuscular injections because both were recorded as parenteral. The dose and type of GCs were recorded inconsistently. Intramuscular GC injections may have been underreported.

DISCLOSURES

The CATCH cohort received support from Canadian affiliates, including Pfizer, AbbVie, Sandoz, Organon, and Celltrion, with previous funding from multiple pharmaceutical companies. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.