Rheumatology International

, Volume 39, Issue 4, pp 723–727 | Cite as

Use of systemic glucocorticoids in patients with psoriatic arthritis by Argentinian and other Latin-American rheumatologists

  • Carolina Aimo
  • Vanesa Laura CosentinoEmail author
  • Gabriel Sequeira
  • Eduardo Kerzberg


To analyse the administration of systemic glucocorticoids (SGC) to patients with Psoriatic arthritis (PsA). Online, anonymous, multiple-choice, closed-ended survey on SGC use in PsA, dose, duration of therapy, and the reason for administration. One hundred and twenty rheumatologists from Argentina (ARG) and 75 from other countries in Latin-America (LAT) completed the survey. Only 6% of the respondents indicated that they did not prescribe SGC, and 65% claimed that they administered them to less than 10% of their patients. Among those physicians who used SGC, 71% prescribed between 5 and 10 mg/day of prednisone, and only 5% over 10 mg/day. Seventy-three percent of the respondents administered SGC for less than 3 months, and 93% associated them with DMARDs, Biological Therapy (BT), or DMARDs plus BT. Clinical indications for SGC were (more than one option was possible): peripheral arthritis (79%), dactylitis (23%), enthesitis (20%), cutaneous involvement (11%), and axial involvement (8%). Thirty-four percent of ARG physicians versus 21% of LAT used SGC in over 10% of their patients (p 0.07) while 76.5% of ARG versus 59% of LAT administered doses higher than 5 mg/day of prednisone (p 0.01). SGC were indicated by most of the rheumatologists surveyed, but only to a reduced number of patients with PsA, at low doses, for short periods of time, associated with DMARDs/BT, and with the aim of treating peripheral joint manifestations. Argentinian physicians tended to prescribe SGC to more patients and at slightly higher doses.


Psoriatic arthritis Spondyloarthritis Glucocorticoids 



The authors wish to thank Professor Ana Insausti for her cooperation in the translation of this research paper.

Author contributions

Both, CA and VC took part in the conception and design of the study; VC and GS took part in the data management and analysis. All the authors write the article and approved the final manuscript.


This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

In view of the fact that this paper is an anonymous, online survey not levelled at patients but at physicians, with the purpose of deriving opinions as to their prescribing pattern of glucocorticoids in patients with psoriatic arthritis, authorisation from the Bioethics Committee was not requested


  1. 1.
    FitzGerald O, Elmamoun M (2017) Psoriatic arthritis. In Kelley- Firestein. Textbook of Rheumatology. Edited by GS Firestein, SE Gabriel, IB McInnes, JR O’Dell. 10th edn. Philadelphia. Elsevier. pp: 1285–1308CrossRefGoogle Scholar
  2. 2.
    Gottlieb A, Korman NJ, Gordon KB, Feldman SR, Lebwohl M, Koo JY, Van Voorhees AS, Elmets CA, Leonardi CL, Beutner KR, Bhushan R, Menter AJ (2008) Guidelines of care for the management of psoriasis and psoriatic arthritis: Sect. 2. Psoriatic arthritis: overview and guidelines of care for treatment with an emphasis on the biologics. Am Acad Dermatol 58(5):851–864CrossRefGoogle Scholar
  3. 3.
    Mease PJ (2011) Psoriatic arthritis: update on pathophysiology, assessment and management. Ann Rheum Dis 70(Suppl 1):77–84CrossRefGoogle Scholar
  4. 4.
    Singh JA, Saag KG, Bridges SL Jr, Akl EA, Bannuru RR, Sullivan MC et al (2016) 2015 American College of Rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis Rheumatol 68(1):1–26CrossRefGoogle Scholar
  5. 5.
    Baker H, Ryan TJ (1968) Generalized pustular psoriasis. A clinical and epidemiological study of 104 cases. Br J Dermatol 80:771–793CrossRefGoogle Scholar
  6. 6.
    Mrowietz U, Domm S (2013) Systemic steroids in the treatment of psoriasis: what is fact, what is fiction? J Eur Acad Dermatol Venereol 27(8):1022–1025. CrossRefGoogle Scholar
  7. 7.
    Mease PJ, Kivitz AJ, Burch FX, Siegel EL, Cohen SB, Ory P, Salonen D, Rubenstein J, Sharp JT, Tsuji W (2004) Etanercept treatment of psoriatic arthritis: safety, efficacy, and effect on disease progression. Arthritis Rheum 50(7):2264–2272CrossRefGoogle Scholar
  8. 8.
    Antoni C, Krueger GG, de Vlam K, Birbara C, Beutler A, Guzzo C, Zhou B, Dooley LT, Kavanaugh A (2005) IMPACT 2 Trial Investigators. Infliximab improves signs and symptoms of psoriatic arthritis: results of the IMPACT 2 trial. Ann Rheum Dis 64(8):1150–1157CrossRefPubMedCentralGoogle Scholar
  9. 9.
    Mease PJ, Gladman DD, Ritchlin CT, Ruderman EM, Steinfeld SD, Choy EH, Sharp JT, Ory PA, Perdok RJ, Weinberg MA (2005) Adalimumab Effectiveness in Psoriatic Arthritis Trial Study Group. Adalimumab for the treatment of patients with moderately to severely active psoriatic arthritis: results of a double-blind, randomized, placebo-controlled trial. Arthritis Rheum 52(10):3279–3289CrossRefGoogle Scholar
  10. 10.
    Kavanaugh A, van der Heijde D, McInnes IB, Mease P, Krueger GG, Gladman DD, Gómez-Reino J, Papp K, Baratelle A, Xu W, Mudivarthy S, Mack M, Rahman MU, Xu Z, Zrubek J, Beutler A (2012) Golimumab in psoriatic arthritis: one-year clinical efficacy, radiographic, and safety results from a phase III, randomized, placebo-controlled trial. Arthritis Rheum 64(8):2504–2517CrossRefGoogle Scholar
  11. 11.
    Mease PJ, Fleischmann R, Deodhar AA, Wollenhaupt J, Khraishi M, Kielar D, Woltering F, Stach C, Hoepken B, Arledge T, van der Heijde D (2014) Effect of certolizumab pegol on signs and symptoms in patients with psoriatic arthritis: 24-week results of a Phase 3 double-blind randomised placebo-controlled study (RAPID-PsA). Ann Rheum Dis 73(1):48–55CrossRefGoogle Scholar
  12. 12.
    Ritchlin C, Rahman P, Kavanaugh A, McInnes IB, Puig L, Li S, Wang Y, Shen YK, Doyle MK, Mendelsohn AM, Gottlieb AB (2014) PSUMMIT 2 Study Group. Efficacy and safety of the anti-IL-12/23 p40 monoclonal antibody, ustekinumab, in patients with active psoriatic arthritis despite conventional non-biological and biological anti-tumour necrosis factor therapy: 6-month and 1-year results of the phase 3, multicentre, double-blind, placebo-controlled, randomised PSUMMIT 2 trial. Ann Rheum Dis 73(6):990–999CrossRefPubMedCentralGoogle Scholar
  13. 13.
    Mease PJ, McInnes IB, Kirkham B, Kavanaugh A, Rahman P, van der Heijde D, Landewé R, Nash P, Pricop L, Yuan J, Richards HB, Mpofu S (2015) FUTURE 1 Study Group. Secukinumab Inhibition of Interleukin-17A in Patients with Psoriatic Arthritis. N Engl J Med 373(14):1329–1339CrossRefGoogle Scholar
  14. 14.
    Cervini C, Leardini G, Mathieu A, Punzi L, Scarpa R (2005) Psoriatic arthritis: epidemiological and clinical aspects in a cohort of 1.306 Italian patients. Reumatismo 57(4):283–290Google Scholar
  15. 15.
    Augustin M, Schafer I, Reich K, Glaeske G, Radtke M (2011) Systemic treatment with corticosteroids in psoriasis–health care provision far beyond the S3-guidelines. J Dtsch Dermatol Ges 9(10):833–838Google Scholar
  16. 16.
    Al-Dabagh A, Al-Dabagh R, Davis SA, Taheri A, Lin HC, Balkrishnan R, Feldman SR (2014) Systemic corticosteroids are frequently prescribed for psoriasis. J Cutan Med Surg 18(3):195–199CrossRefGoogle Scholar
  17. 17.
    Gossec L, Smolen JS, Ramiro S, de Wit M, Cutolo M, Dougados M et al (2016) European league against rheumatism recommendations for the management of psoriatic arthritis with pharmacological therapies: 2015 update. Ann Rheum Dis 75:499–510CrossRefGoogle Scholar
  18. 18.
    Coates LC, Kavanaugh A, Mease PJ, Soriano ER, Laura Acosta-Felquer M, Armstrong AW et al (2016) Group for Research and Assessment of Psoriasis and Psoriatic Arthritis 2015 treatment recommendations for psoriatic arthritis. Arthritis Rheumatol 68(5):1060–1071Google Scholar
  19. 19.
    Turkiewicz AM, Moreland LW (2007) Psoriatic arthritis: current concepts on pathogenesis-oriented therapeutic options. Arthritis Rheum 56(4):1051–1066CrossRefGoogle Scholar
  20. 20.
    Coates LC, Helliwell PS (2016) Psoriasis flare with corticosteroid use in psoriatic arthritis. Br J Dermatol 174(1):219–221CrossRefGoogle Scholar
  21. 21.
    Pérez-Ruiz F, Carmona L, Yébenes MJ, Pascual E, de Miguel E, Ureña I et al (2011) GEMA Study Group, Sociedad Española de Reumatología. An audit of the variability of diagnosis and management of gout in the rheumatology setting: the gout evaluation and management study. J Clin Rheumatol 17:349–355CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Rheumatology ServiceJ. M. Ramos Mejía HospitalBuenos AiresArgentina

Personalised recommendations