Conclusions

Biologic therapies were associated with a significant GC-sparing effect in patients with RA. A progressive and significant reduction in GC doses was observed during the first six months of follow-up, with 31 patients (51.7%) achieving a daily GC dose ≤5 mg. Baseline DAS28-CRP was significantly lower in patients who achieved this GC dose threshold at M6.

Despite this favorable effect, complete GC withdrawal remained uncommon, occurring in only one patient (1.7%), highlighting the persistent challenges of corticosteroid discontinuation in patients with long-standing RA. This observation is consistent with previous studies showing that, although GC tapering is achievable in a substantial proportion of patients receiving biologic or targeted therapies, complete withdrawal often remains difficult to attain.

Overall, these findings suggest that reducing GC exposure to the lowest effective dose represents a realistic therapeutic goal for many patients with RA. Nevertheless, prospective multicenter studies involving larger patient populations and longer follow-up periods are needed to confirm these findings, identify predictors of successful GC withdrawal, and optimize tapering strategies while maintaining sustained disease control.