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Morning stiffness response with delayed-release prednisone after ineffective course of immediate-release prednisone

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 m...

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Autores principales: Alten, R, Holt, R, Grahn, A, Rice, P, Kent, J, Buttgereit, F, Gibofsky, A
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Informa Healthcare 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4732433/
https://www.ncbi.nlm.nih.gov/pubmed/26114379
http://dx.doi.org/10.3109/03009742.2015.1038582
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author Alten, R
Holt, R
Grahn, A
Rice, P
Kent, J
Buttgereit, F
Gibofsky, A
author_facet Alten, R
Holt, R
Grahn, A
Rice, P
Kent, J
Buttgereit, F
Gibofsky, A
author_sort Alten, R
collection PubMed
description 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.
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spelling pubmed-47324332016-02-16 Morning stiffness response with delayed-release prednisone after ineffective course of immediate-release prednisone Alten, R Holt, R Grahn, A Rice, P Kent, J Buttgereit, F Gibofsky, A Scand J Rheumatol Short Communication 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. Informa Healthcare 2015-09-03 2015-06-26 /pmc/articles/PMC4732433/ /pubmed/26114379 http://dx.doi.org/10.3109/03009742.2015.1038582 Text en © 2015 Informa healthcare on license from Scandinavian Rheumatology Research Foundation http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way.
spellingShingle Short Communication
Alten, R
Holt, R
Grahn, A
Rice, P
Kent, J
Buttgereit, F
Gibofsky, A
Morning stiffness response with delayed-release prednisone after ineffective course of immediate-release prednisone
title Morning stiffness response with delayed-release prednisone after ineffective course of immediate-release prednisone
title_full Morning stiffness response with delayed-release prednisone after ineffective course of immediate-release prednisone
title_fullStr Morning stiffness response with delayed-release prednisone after ineffective course of immediate-release prednisone
title_full_unstemmed Morning stiffness response with delayed-release prednisone after ineffective course of immediate-release prednisone
title_short Morning stiffness response with delayed-release prednisone after ineffective course of immediate-release prednisone
title_sort morning stiffness response with delayed-release prednisone after ineffective course of immediate-release prednisone
topic Short Communication
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4732433/
https://www.ncbi.nlm.nih.gov/pubmed/26114379
http://dx.doi.org/10.3109/03009742.2015.1038582
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