Loading...
In patients with rheumatoid arthritis (RA), circadian increases in inflammatory cytokines (such as interleukin-6) during sleep seem to cause morning stiffness. Glucocorticoids alleviate symptoms and lower proinflammatory cytokine concentrations, but when patients take their morning doses upon awakening, they can miss the opportunity to reduce morning stiffness optimally. A new formulation of prednisone has a coating that bursts 4 hours after ingestion when it is penetrated by water; when taken at bedtime, the full dose is released at about 2 am.
In a double-blind, placebo-controlled, manufacturer-supported study, researchers randomized 288 patients with RA (most for at least 5 years) to either continue their current regimens of low-dose pred…