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

Annals of the Rheumatic Diseases
F ButtgereitKenneth G Saag

Abstract

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). 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. MR prednisone plus DMARD treatment produced higher response rates for ACR20 (48% vs 29%, p<0.001) and ACR50 (22% vs 10%, p<0.006) and a greater median relative reduction from baseline in morning stiffness (55% vs 35%, p<0.002) at week 12 than placebo plus DMARD treatment. Significantly greater reductions in severity of RA (Disease Activity Score 28) (p<0.001) and fatigue (Functional Assessment of Chronic Illness Therapy-Fatigue score) (p=0.003) as well as a greater improve...Continue Reading

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Citations

Nov 28, 2012·Rheumatology International·Boris M PfeifferEdgar Kraus
Jan 22, 2013·Drugs·Roberto CaporaliCarlomaurizio Montecucco
Nov 10, 2013·La Revue de médecine interne·T LequerréO Vittecoq
Dec 4, 2012·Antioxidants & Redox Signaling·Melissa WilkingNihal Ahmad
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Jan 23, 2015·Arthritis Research & Therapy·Maurizio CutoloCarmen Pizzorni
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Apr 19, 2013·Expert Opinion on Pharmacotherapy·Frank Buttgereit, Allan Gibofsky
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Sep 26, 2015·International Journal of Rheumatic Diseases·Chi Chiu MokUNKNOWN Asia Pacific Morning Stiffness in Rheumatoid Arthritis Expert Panel
Nov 8, 2015·Arthritis Care & Research·Jasvinder A SinghTimothy McAlindon
Nov 8, 2015·Arthritis & Rheumatology·Jasvinder A SinghTimothy McAlindon
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May 22, 2020·Expert Review of Clinical Pharmacology·Onorina BerardicurtiPaola Cipriani
Jun 5, 2020·Expert Opinion on Drug Safety·Roy Fleischmann, Daniel E Furst

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