Modified-release prednisone: a guide to its use in rheumatoid arthritis

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A low-dose, modified-release (MR) formulation of prednisone (Rayos®, Lodotra®), administered in the evening, has been developed to counter the circadian rise in pro-inflammatory cytokine levels that contributes to disease activity in rheumatoid arthritis. In well-designed 12-week trials, the proportion of patients with a ≥20 % improvement in the signs and symptoms of rheumatoid arthritis according to American College of Rheumatology criteria (primary endpoint) was significantly greater with MR prednisone than with placebo in one trial, and a significantly greater mean relative reduction in the duration of morning stiffness (primary endpoint) was seen with MR prednisone than with immediate-release prednisone in the other trial. Treatment with evening MR prednisone for up to 12 months was generally well tolerated.

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