To the Editors:

We thank Dr. van Tuyl and colleagues for their positive comments about the recent ACR 2008 recommendations for the use of nonbiologic and biologic DMARDs in RA. We agree that optimally RA guidelines should address glucocorticoid use, and recognize this as one limitation of the existing document. We anticipate that future updates to these recommendations will incorporate a discussion of this important topic.

Kenneth G. Saag MD, MSc*, Daniel E. Furst MD†, * University of Alabama, Birmingham, † University of California, Los Angeles.