Efficacy, safety and mechanism of action of modified-release prednisone in rheumatoid arthritis

Lynsey Clarke, John Kirwan*

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

6 Citations (Scopus)

Abstract

Glucocorticoids (GCs) provide a powerful and widely used anti-inflammatory and disease-modifying therapy for rheumatoid arthritis (RA). However, concerns about adverse effects are driving efforts to find 'safer' GC or GC analogues. One novel approach has been to change the timing of GC delivery, targeting the early hours of the morning to suppress the observed circadian peak in interleukin-6 (IL-6). The CAPRA-1 study has shown that this produces a clinically useful beneficial improvement in morning stiffness and mechanistic studies have shown that this correlates with a strong suppression of the IL-6 early morning peak. With no obvious additional adverse reactions, this improvement in the therapeutic ratio offers additional treatment options in RA, and perhaps in other inflammatory diseases that show circadian variation in symptoms. © The Author(s), 2012.

Original languageEnglish
Pages (from-to)159-166
Number of pages8
JournalTherapeutic advances in musculoskeletal disease
Volume4
Issue number3
DOIs
Publication statusPublished - 1 Jun 2012

Keywords

  • chronotherapy
  • glucocorticoids
  • modified-release prednisone
  • rheumatoid arthritis
  • safety

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