Low-dose prednisone chronotherapy for rheumatoid arthritis: a randomised clinical trial (CAPRA-2)

Frank Buttgereit*, Daksha Mehta, John Kirwan, Jacek Szechinski, Maarten Boers, Rieke E. Alten, Jerzy Supronik, Istvan Szombati, Ulrike Romer, Stephan Witte, Kenneth G. Saag

*Corresponding author for this work

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

116 Citations (Scopus)

Abstract

Objective To assess the efficacy and safety of low-dose prednisone chronotherapy using a new modified-release (MR) formulation for the treatment of rheumatoid arthritis (RA).

Methods In this 12-week, double-blind, placebo-controlled study, patients with active RA (n=350) were randomised 2:1 to receive MR prednisone 5 mg or placebo once daily in the evening in addition to their existing RA disease-modifying antirheumatic drug (DMARD) treatment. The primary end point was the percentage of patients achieving a 20% improvement in RA signs and symptoms according to American College of Rheumatology criteria (ie, an ACR20 response) at week 12. Changes in morning pain, duration of morning stiffness, 28-joint Disease Activity Score and health-related quality of life were also assessed.

Results MR prednisone plus DMARD treatment produced higher response rates for ACR20 (48% vs 29%, p

Conclusion Low-dose MR prednisone added to existing DMARD treatment produced rapid and relevant improvements in RA signs and symptoms. ClinicalTrials.gov, number NCT00650078

Original languageEnglish
Pages (from-to)204-210
Number of pages7
JournalAnnals of the Rheumatic Diseases
Volume72
Issue number2
DOIs
Publication statusPublished - Feb 2013

Keywords

  • RECOMMENDATIONS
  • MANAGEMENT
  • THERAPY
  • EFFICACY
  • GLUCOCORTICOID TREATMENT
  • DOUBLE-BLIND
  • REMISSION
  • AMERICAN-COLLEGE
  • JOINT DESTRUCTION
  • CIRCADIAN-RHYTHMS

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