Morning stiffness response with delayed-release prednisone after ineffective course of immediate-release prednisone. Academic Article uri icon

Overview

abstract

  • OBJECTIVE: To assess morning stiffness in rheumatoid arthritis (RA) patients switched from immediate-release (IR) to delayed-release (DR) prednisone. METHOD: Circadian Administration of Prednisone in Rheumatoid Arthritis-1 (CAPRA-1) is a 12-week, randomized, multicentre, active-controlled study of morning stiffness that consisted of a double-blind phase and a 9-month open-label extension. Patients receiving IR prednisone with no significant improvement after the double-blind study were switched to DR prednisone. Morning stiffness duration and median absolute and relative changes in pain and global assessment were evaluated (3, 6, and 9 months). RESULTS: In patients switched from IR to DR prednisone (n=110), statistically significant reductions in morning stiffness occurred over 3 months and were sustained for 9 months. Absolute reduction of morning stiffness was ~50 min with >40% relative reduction at each visit. Interleukin (IL)-6 levels were reduced by the same amount. Statistically significant and clinically meaningful mean reductions in morning stiffness were maintained at >67 min at each visit along with significant improvements in pain and patient global assessment. There was no evidence of tachyphylaxis seen over the 9-month study. CONCLUSIONS: Patients receiving disease-modifying anti-rheumatic drugs (DMARDs) and IR prednisone who had not had significant reductions in morning stiffness demonstrated statistically significant and clinically meaningful improvements when switched to DR prednisone.

publication date

  • June 26, 2015

Research

keywords

  • Arthritis, Rheumatoid
  • Circadian Rhythm
  • Delayed-Action Preparations
  • Prednisone
  • Range of Motion, Articular

Identity

PubMed Central ID

  • PMC4732433

Scopus Document Identifier

  • 84943271223

Digital Object Identifier (DOI)

  • 10.3109/03009742.2015.1038582

PubMed ID

  • 26114379

Additional Document Info

volume

  • 44

issue

  • 5