Primary Article

Bolus Intramuscular Methylprednisolone Acetate as a Therapeutic Adjunct in Rheumatoid Arthritis

Authors: JOEL KOVARSKY MD, SAMUEL B. PEGRAM MD

Abstract

ABSTRACTEighty adult patients with classical or definite rheumatoid arthritis were given 200 bolus injections of intramuscular methylprednisolone acetate (MPA) over four years. This was used strictly as a therapeutic adjunct for polyarticular flares (≥5 swollen joints), not as a singular form of long-term treatment. Good clinical responses, lasting an average of eight weeks, were obtained in the vast majority of patients. Severe toxicity was minimal. Postbolus responses to intravenous ACTH stimulation were measured in 12 patients. We believe that intramuscular bolus injections, used cautiously in carefully selected patients with rheumatoid arthritis, are relatively useful, convenient, inexpensive, and safe.

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