Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Practice Point
  • Published:

Is a step-down regimen more effective than a step-up regimen in the treatment of early rheumatoid arthritis?

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

References

  1. Boers M et al. (1997) Randomised comparison of combined step-down prednisolone, methotrexate and sulphasalazine with sulphasalazine alone in early rheumatoid arthritis. Lancet 350: 309–318

    Article  CAS  Google Scholar 

  2. Goekoop-Ruiteman YP et al. (2005) Clinical and radiographic outcomes of four different treatment strategies in patients with early rheumatoid arthritis (the BeSt study): a randomized trial. Arthritis Rheum 52: 3381–3390

    Article  Google Scholar 

  3. Landewé RB et al. (2002) COBRA combination therapy in patients with early rheumatoid arthritis: long-term structural benefits of a brief intervention. Arthritis Rheum 46: 347–356

    Article  Google Scholar 

  4. Wassenberg S et al. (2005) Very low-dose prednisolone in early rheumatoid arthritis retards radiographic progression over two years: a multicentre, double-blind, placebo-controlled trial. Arthritis Rheum 52: 3371–3380

    Article  CAS  Google Scholar 

  5. van Tuyl LH et al. (2007) Why are Dutch rheumatologists reluctant to use the COBRA treatment strategy in early rheumatoid arthritis? Ann Rheum Dis 66: 974–976

    Article  Google Scholar 

Download references

Acknowledgements

The synopsis was written by Bryony Mearns, Associate Editor, Nature Clinical Practice.

Author information

Authors and Affiliations

Authors

Ethics declarations

Competing interests

The author declares no competing financial interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Keystone, E. Is a step-down regimen more effective than a step-up regimen in the treatment of early rheumatoid arthritis?. Nat Rev Rheumatol 4, 396–397 (2008). https://doi.org/10.1038/ncprheum0861

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ncprheum0861

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing