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Oral prednisone effective pretreatment option to IV for patients with rheumatoid arthritis
Patients with rheumatoid arthritis were effectively treated with a smaller dose of oral prednisone as an alternative to IV methylprednisolone before rituximab treatment in a recent study.
Researchers investigated 50 patients (mean age, 52.2 years; 42 women) with rheumatoid arthritis during an open-label trial of 40 mg oral prednisone given 30 minutes before rituximab infusion (1,000 mg at days 0 and 14) as a preventive measure against acute infusion reactions (AIRs). Endpoints were AIRs within 24 hours of initial infusion, AIRs during 24 hours after the second infusion and any adverse events (AE) during the study. Patients were examined at screening, days 0 and 14 and weeks 4, 8, 16 and 26.
John D. Carter
Fourteen patients experienced AIRs within 24 hours of initial infusion, and four AIRS occurred within 24 hours of the second infusion. One patient discontinued treatment because of wheezing and bronchospasm. During the study, 40 patients experienced an AE; upper respiratory infection was most common (n=12). At weeks 8, 16 and 26, patients improved significantly in Disease Activity Score 28 (DAS28) and Health Assessment Questionnaire-Disability Index (HAQ-DI) (DAS28 mean scores 4.11, 3.86 and 3.98; HAQ-DI, 1.03, 0.86 and 0.92, respectively) compared with screening (DAS28, 5.64; HAQ-DI, 1.4).
“The efficacy of 40 mg oral prednisone was equal to 100 mg IV methylprednisolone” or the equivalent of 120 mg oral prednisone, researcher John D. Carter, MD, associate professor and chief of the division of rheumatology at the University of South Florida, told Healio.com. “Patients can safely be pretreated with oral prednisone prior to their rituximab for RA. This is quicker and more convenient for the patient. They could even take their oral dose of prednisone prior to coming to the infusion center.”