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Delayed-release prednisone may reduce morning stiffness in patients with RA
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A study of patients with rheumatoid arthritis showed switching from immediate-release prednisone to Rayos significantly decreased morning stiffness, according to recently published data.
Researchers studied data from 288 patients with rheumatoid arthritis (RA) who were randomized to either delayed-release prednisone (Rayos; Horizon Pharma Inc.) or immediate-release prednisone followed by a switch to delayed-release prednisone and were included in the double-blind Circadian Administration of Prednisone in Rheumatoid Arthritis-1 (CAPRA-1) trial conducted at 29 centers in Germany and Poland.
Patients recorded daily diary entries to document waking time, stiffness, time of resolution and pain intensity on a VAS. Diary data was compared following the switch.
Concomitant use of disease-modifying anti-rheumatic drugs included 76% of patients who received methotrexate, 14% of patients who received leflunomide and 12% of patients who received sulfasalazine.
A significant mean reduction in morning stiffness was observed at 3 months, 6 months and 9 months, representing a reduction from baseline by about 50 minutes. About a 50% relative reduction was observed at 3 months, 6 months and 9 months in patients who switched to delayed-release prednisone. At 3 months, patients who switched had results similar to patients who were initially randomized to delayed-release prednisone.
The greatest reduction in the duration of morning stiffness was observed at 6 months, with a minimum of a 67-minute reduction of the mean duration of morning stiffness at each visit. At 3 months, a significant improvement in pain on a VAS was observed and was stabilized at 9 months. Patient global assessment also improved significantly at 3 months and 6 months and was stabilized at 9 months. The median levels of interleukin-6 were reduced from baseline 1,055 IU/L to 500 IU/L at 9 months.
At 9 months, 12.2% of patients who switched were deemed to have low disease activity (a 75% improvement from baseline) and the number of patients with high disease activity decreased from 53.5% to 46%. – by Shirley Pulawski
Disclosure s : The researchers report editorial support, and the study was funded by Horizon Pharma Inc.
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