Circadian variation in plasma IL-6 and the role of modified-release prednisone in polymyalgia rheumatica

Samy A. Zakout*, Lynsey L. Clarke, David Jessop, Rainer H. Straub, John R. Kirwan

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)

2 Citations (Scopus)

Abstract

Aims: To investigate the circadian variation in IL-6 and effects of morning and night time glucocorticoids in polymyalgia rheumatica.

Methods: Cytokines were measured in newly diagnosed polymyalgia rheumatica over two 24-h periods, 2 weeks apart during which they received 7 mg/day of modified-release prednisone at night or morning prednisolone. All patients then received 15 mg/day morning prednisolone. Morning IL-6 concentrations were measured after 2 weeks. Morning stiffness, changes in peak IL-6 levels and area under the curve were compared.

Results: IL-6 followed a circadian rhythm with a peak at 04h00. Modified-release prednisone caused greater reduction of IL-6 and area under the curve.

Conclusion: IL-6 showed marked circadian variation. The possibility that modified-release prednisone offers a treatment advantage over standard therapy should be tested in a larger study.

Original languageEnglish
Pages (from-to)431-439
Number of pages9
JournalInternational Journal of Clinical Rheumatology
Volume9
Issue number5
DOIs
Publication statusPublished - 1 Jan 2014

Keywords

  • chronobiology
  • circadian variation cytokines
  • glucocorticoids
  • morning stiffness
  • polymyalgia rheumatica
  • treatment

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