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For rheumatoid arthritis (RA) patients who are taking a standard glucocorticoid (steroid) medication, switching to a modified-release version of prednisone may improve RA symptoms. These results were published in Clinical and Experimental Rheumatology.

Steroid drugs such as prednisone can improve RA symptoms, and may be especially useful during a flare-up of symptoms or while waiting for a slower-acting drug (such as the disease-modifying antirheumatoic drugs) to take effect.

Standard steroid medications are typically taken in the morning and may have limited effect on symptoms that occur early in the day, such as morning stiffness. Modified-release prednisone can be taken at bedtime and becomes effective a few hours later.

To explore the effect of switching from a standard steroid medication to modified-release prednisone, researchers in Italy conducted a study among 950 RA patients. All of the patients were taking both a steroid medication and a disease-modifying antirheumatoic drug such as methotrexate. Patients were switched from their previous steroid medication to modified-release prednisone.

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  • At the start of the study, the average duration of morning stiffness was 58 minutes. After four months of treatment with modified-release prednisone, the average duration of morning stiffness was 32 minutes.
  • Pain intensity and disease activity (assessed by the DAS28 score) had also improved after four months.

These results suggest that for RA patients who are being treated with a standard steroid medication, switching to modified-release prednisone may improve symptoms and reduce RA activity.

Reference: Cutolo M, Iaccarino L, Doria A et al. Efficacy of the switch to modified-release prednisone in rheumatoid arthritis patients treated with standard glucocorticoids. Clinical and Experimental Rheumatology. Early online publication February 15, 2013.