The current relevance and use of prednisone in rheumatoid arthritis

Abstract

Prednisone is an old and very valuable drug in clinical use for over 60 years by now. It is well known by physicians and widely used for different kinds of inflammatory states including rheumatoid arthritis (RA). Clinical trials during the last 20 years have changed its clinical use, particularly with regards to dosage. Today, rheumatologists are treating their patients much more likely over a long period of time using a low-dose scheme. The effectiveness and safety of this low-dose use is the objective of the current clinical research and shall be enlightened in this drug profile. It is also featuring current knowledge about the value of modified-release prednisone with regards to the just published results of the 2nd Circadian Administration of Prednisone in Rheumatoid Arthritis trial. Moreover, the mechanisms of action of prednisone and its relatives will be summed up.

Bullous pemphigoid outcome is associated with CXCL10-induced matrix metalloproteinase 9 secretion from monocytes and neutrophils but not lymphocytes

“…In this line it was shown that CD14 1 CD56 1 monocytes also expressing CD16 were more prone to express inflammatory cytokines, such as IL-1b and IL-23, and were expanded in conditions associated with inflammatory and autoimmune diseases. [39][40][41] Although this monocyte subset still need to be investigated in patients with BP, one can notice that IL-23 is overexpressed in the serum of patients with BP compared with expression in age-and sexmatched control subjects and is even increased in the serum of patients with BP who later experience a relapse. 6 Because CXCL10 increases its own production by monocytes in some patients with BP, this could further amplify MMP-9 production in those patients.…”

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

“…In combination with synthetic DMARDs, such as methotrexate, radiographic joint damage is reduced when used over a longer period (2–4 years), even after discontinuing IR prednisone. 35 Since MR prednisone is virtually the same drug with almost identical pharmacodynamics and just an envelope ensuring a delayed liberation, a similar effect could be concluded on the long run.…”

“… 34 Details on this topic and the (non)genomic effects of prednisone are extensively discussed elsewhere. 35 …”

Steroids in the Treatment of Chronic Diseases

“…Glucocorticoids have the ability to reduce signs and symptoms in inflammatory disorders; therefore, they are widely used to treat RA [53]. Prednisone is an important drug which is used to treat different kinds of inflammatory conditions including RA [54].…”