EFFICACY OF ORAL PREDNISONE VERSUS INTRAMUSCULAR DEPOT METHYLPREDNISOLONE ACETATE FOR REDUCTION OF DISEASE ACTIVITY IN EARLY RHEUMATOID ARTHRITIS WITH MODERATE TO SEVERE DISEASE ACTIVITY: A DOUBLE-BLIND EXPLORATORY RANDOMIZED CONTROL TRIAL

This is a double-blind, double dummy RCT to compare the efficacy of oral prednisone versus IM MPS in RA with moderate-high disease activity. The eligible patients will be recruited to either oral prednisone (with IM placebo) arm or IM MPS (with oral placebo) arm. The placebo being used is oral mutivitamin tablets for prednisone and normal saline in sealed sterile vials for IM MPS. The dose of treatment will be low-dose (7.5 mg of prednisone or 80mg of depomedrol) as per standard of care for RA. All patients will be given DMARDs as per institute policy, initiating from methotrexate, and adjusting dose as per treat-to-target policy. The disease activity and other measures will be followed up every 3 monthly or more frequently, as per disease activity of the patient. Any increase in disease activity requiring steroids during the trial duration will be treated with low-dose steroids as per arm of the patient, along with the placebo, to maintain blinding. All adverse effects will also be followed up. Primary outcome will be assessed at 1 year