Steroid treatment for arthritis ups pneumonia risk

NEW YORK, Mar 17 (Reuters) Patients with rheumatoid arthritis who are treated with low-dose prednisone have an increased risk of coming down with pneumonia, a new study indicates.

However, the findings also show that most other drugs used to treat arthritis don't have this drawback.

Prednisone, a steroid, tends suppresses the immune system and at high enough doses this could increase the chances of infection. ''If the results of this study are correct, they may undermine the current belief that low-dose prednisone is safe,'' Dr. Frederick Wolfe, with the Arthritis Research Center Foundation in Wichita, Kansas, and his colleagues suggest.

Even though prednisone is commonly used to treat arthritis patients, there have been no studies looking at it's effect on the risk of pneumonia -- which is one of the major causes of death in patients with rheumatoid arthritis, the authors point out.

Wolfe's team followed 16,788 arthritis patients, average age 62 years, participating in the National Data Bank for Rheumatic Diseases study. The subjects completed questionnaires early in 2001 and every 6 months for up to 3.5 years.

The investigators report in the medical journal Arthritis&Rheumatism that the most common treatments were methotrexate, prednisone, Remicade, hydroxychloroquine and Enbrel.

During follow-up, there were 749 hospitalisations for pneumonia. After adjusting for factors such as smoking, age and arthritis severity, the researcher found that prednisone was associated with a 70 per cent increased risk of pneumonia.

There was no significantly increased risk associated with so-called TNF-blockers -- Remicade, Enbrel or Humira -- or with methotrexate, hydroxychloroquine or sulfasalazine.

''Prednisone use is common in rheumatoid arthritis and is therefore a potentially important health risk,'' Wolfe's team concludes. They point out, however, that their data ''do not address the issue of net benefit,'' so discontinuing prednisone ''might provoke equally undesirable adverse effects.'' REUTERS KD SP1042