Researchers have been criticised by an expert for ignoring data and “beating on the same old tired drum” to bash glucocorticoids.

In a letter to the Annals of the Rheumatic Diseases rheumatologist Dr Maarten Boers from Amsterdam said he was surprised that a meta-analysis published by Roubille et al. had confirmed the cardiovascular risks of GCs.

Particularly as a meta-analysis of RCTs that he had participated in had found no increased cardiovascular risk.

However a quick look at the methodology explained all — the authors had excluded all studies reporting on less than 400 patients, he said.

“There are good reasons not to rely solely on RCTs for a good estimate of safety issues (relatively short exposure, selected population, low sample size) but there is not a good reason to exclude these studies in a meta-analysis simply because they are perceived not to be large enough,” he wrote.

There are even better reasons not to rely solely on observational studies to get a good estimate of safety issues related to GC, he said.

“This review unfortunately recycles flawed observational data, ignores data from RCTs and thus beats on the same old tired drum to bash GC”.

“It does not help to answer the important unanswered questions on the real balance of benefit and harm, and the place of GC in our therapeutic armamentarium,” he added.