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NEW YORK (Reuters Health) - A delayed-release prednisone tablet taken at night is more effective than immediate-release prednisone taken in the morning in reducing morning joint stiffness in people with rheumatoid arthritis (RA), according to a study published this week.
A new modified-release formulation of the drug (SKYE Pharma) adapts the release of the administered drug (prednisone) to the circadian (day-night) rhythms of the disease symptoms, and improves the performance of the treatment, Dr. Frank Buttgereit and associates explain in the January 19th issue of The Lancet.
In their study of 288 patients with active RA, Buttgereit, at Charite University Medicine Berlin, and colleagues assigned half to modified-release prednisone and the other half to standard (immediate-release) prednisone. The modified-release tablet was taken at bedtime and released the prednisone four hours after ingestion; this method was compared to morning administration of immediate release (standard) prednisone.
After 12 weeks, the average relative change in duration of morning stiffness was significantly higher with the delayed-release prednisone (-22.7 percent versus -0.4 percent). Absolute average reductions were 44 minutes and 23 minutes, respectively.
The difference in duration of morning stiffness between groups was significant at 2 weeks, Buttgereit's group reports, plateauing from week 7 on. The safety profile was the same for both treatments.
"Our results," the investigators conclude, "have confirmed that the new modified-release formulation is clinically and statistically better than the conventional immediate-release preparation with regard to morning stiffness of the joints."
SOURCE: The Lancet, January 19, 2008.
