Efficacy and safety of modified-release prednisone in patients with rheumatoid arthritis

Abstract

The introduction of modified-release (MR) prednisone adds a drug with encouraging potential to the armamentarium of the rheumatologist. In particular, for patients experiencing a reduced quality of life due to prolonged morning stiffness, it is a promising therapeutic approach. Two clinical trials and one open-label observational study investigated the effectiveness of MR prednisone in reducing rheumatoid arthritis-related morning stiffness for both new and current users of corticosteroids. The efficacy and safety of MR prednisone use in rheumatoid arthritis patients are reviewed in this article. This includes pivotal trials as well as pathophysiological considerations and clinical implications.

Risk of Major Adverse Cardiovascular Events in Patients With Rheumatoid Arthritis

“…Lastly, a frequently used anti-inflammatory medication in RA, prednisone has shown long-term adverse effects, such as hypertension, weight gain, and impaired glucose tolerance, which are all modifiable risk factors for MI [ 22 - 23 ]. Other pharmacotherapy for RA includes tumor necrosis factor (TNF) alpha inhibitors, methotrexate, and hydroxychloroquine, which have been shown to reduce the likelihood of MI [ 13 , 24 ].…”

Comprehensive genome analyses ofSellimonas intestinalis, a potential biomarker of homeostasis gut recovery

“…The biological source of this isolate was a stool sample from a 23-year-old woman that despite being healthy at the time of sample collection, has a diagnosis of idiopathic rheumatoid arthritis, for this reason she was under treatment with Prednisone, a synthetic corticosteroid with glucocorticoid modulation, which support its anti-inflammatory effect and has proven as effective and safe for treatment of patients suffering this pathology. 20 The individual consumes in addition Chlorella (a microalgae containing omega-3 fatty acids and carotenoids with antioxidant effect that have been proposed as a potential source of renewable nutrition), 21 vitamin E with selenium and Korean ginseng. The individual did not use any antimicrobial treatment during the six months prior to the sample collection.…”

“…These results are of importance, because these types of genes are determinants for the realization of metabolic processes that lead to the production of short-chain fatty acid (SCFA) during glucose fermentation, 10 mainly butyric acid, 31 which It has been proposed as one of the characteristics of the candidate members for healthy microbiota. 11 In the specific case of the patient from whom the isolate studied in this work was obtained despite the immunosuppression caused as a possible consequence of the anti-inflamatory effect of Prednisone (the corticosteroid consumed as treatment of rheumatoid arthritis) 20 , the healthy lifestyle habits and the consumption of substances with potential restorative effect of the gut microbiota as Chlorella (the microalgae consumed by the donor individual because has shown potential as antioxidant and treatment for different health conditions) 21 , they could contribute to the restored effect of the Microbiota, and the presence of S. intestinallis could then be complying with the hypothesis as a biomarker of the recovery of intestinal homeostasis.…”

Glucocorticoid chronotherapy: a mini-review

“…CAPRA-1 aimed to prove the efficacy and safety of MR prednisone compared to immediate release (IR) prednisone, while CAPRA-2 focused on MR prednisone, as an additional GC therapy to an existing medication with DMARDs. 47 CAPRA-1 included 288 patients, already taking IR-prednisone for RA, who were randomized 1:1 to get MR-prednisone in the evening, or continuing IR-prednisone in the morning. The patients have been treated for 12 weeks in both arms.…”