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Comparison of three pulse methylprednisolone regimens in the treatment of rheumatoid arthritis.

Twenty-nine patients with active rheumatoid arthritis entered a 6-week, parallel, randomized, double blind trial, comparing 1000 mg IV-methylprednisolone (MP), 320 mg IV-MP and 320 mg IM-MP. Although clinical benefit was noted in all groups, there were no differences among groups for duration of benefit (days: 1000 mg IV: 23.4; 320 mg IM: 17.2; 320 mg IV: 21.9) (p = 0.72), patient global scale (p = 0.57), or MD global scale (p = 0.36). Power to tell a 33% difference among groups for joint tenderness and patient global scale was 0.64 and 0.78. No serious drug related toxicity occurred. This preliminary study in a small patient group suggests that no large differences (33%) can be discerned among these 3 regimens. However, a larger study is indicated to reduce possible beta errors.