To the Editor: Kirwan et al. (July 20 issue)1 found that “in patients with early, active rheumatoid arthritis, prednisolone (7.5 mg daily) given for two years in addition to other treatments substantially reduced the rate of radiologically detected progression of disease.” Rheumatoid arthritis is a disease that lasts 20 to 25 years, and the ultimate goal of a therapeutic strategy is to reduce the cumulative pain, disability, side effects, economic impact, and mortality over the course of the illness. Long-term, prospective observational studies of prednisone use show very disquieting results. With the use of average prednisone doses (6.9 mg per.
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