In what clinical situations would you favor IM methylprednisolone over a short oral prednisone taper for managing an RA flare?

Oral prednisone is a pro-drug - it needs to be activated by the liver into prednisolone to work. In addition, if the patient is challenged by GI absorption or has significantly low serum albumin, this reduces the effect of oral prednisone. Those situations would be my greatest concern for such a cho...

I am not an RA expert, however, I am well-versed in the use of IM steroids for flares.

After Dr. Petri's FLOAT study in SLE (Danowski PMID: 16395750), we have utilized IM steroids instead of daily po prednisone as our "go-to" treatment of choice as much as we can over Medrol dose packs and qd predni...