Low-dose prednisone chronotherapy for rheumatoid arthritis: a randomised clinical trial (CAPRA-2)
Annals of Rheumatic Diseases,  Clinical Article

Buttgereit F et al. – Low–dose modified–release (MR) prednisone added to existing disease–modifying antirheumatic drug (DMARD) treatment produced rapid and relevant improvements in rheumatoid arthritis (RA) signs and symptoms.

Methods
  • 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.

Results
  • 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 improvement in physical function (36–item Short–Form Health Survey score) (p<0.001) were seen at week 12 for MR prednisone versus placebo.
  • The incidence of adverse events was similar for MR prednisone (43%) and placebo (49%).

Please login or register to follow this author.
► Click here to access PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Rheumatology

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Rheumatology Articles

1 Homeopathy in the treatment of fibromyalgia- A comprehensive literature-review and meta-analysis Complementary Therapies in Medicine, August 15, 2014    Evidence Based Medicine    Review Article

2 Coffee or tea consumption and the risk of rheumatoid arthritis: A meta-analysis Clinical Rheumatology, October 15, 2014    Clinical Article

3 The comparative safety of TNF inhibitors in rheumatoid arthritis - a meta-analysis update of 44 randomized controlled trials American Journal of Medicine, October 6, 2014    Clinical Article

4 Drug-associated cutaneous vasculitis: Study of 239 patients from a single referral center The Journal of Rheumatology, September 25, 2014    Clinical Article

5 Rituximab for the treatment of relapses in ANCA-associated vasculitis Arthritis & Rheumatism, August 1, 2014    Clinical Article

6 Lupus classification criteria expanded; treat-to-target approach gains support Full Text The Rheumatologist, July 24, 2014    Free full text

7 Fish consumption and risk of rheumatoid arthritis: A dose-response meta-analysis Arthritis Research & Therapy, October 8, 2014    Evidence Based Medicine    Review Article

8 The impact of statins therapy on disease activity and inflammatory factor in patients with rheumatoid arthritis: A meta-analysis Clinical and Experimental Rheumatology Online, October 27, 2014    Evidence Based Medicine    Clinical Article

9 Efficacy and safety of ginger in osteoarthritis patients: A meta-analysis of randomized placebo-controlled trials Osteoarthritis and Cartilage , October 28, 2014    Evidence Based Medicine    Clinical Article

10 Early predictors of prognosis in juvenile idiopathic arthritis: A systematic literature review Annals of Rheumatic Diseases, August 29, 2014    Review Article

11 Homeopathy in the treatment of fibromyalgia—A comprehensive literature-review and meta-analysis Complementary Therapies in Medicine, October 9, 2014    Clinical Article

12 Alcohol consumption as a preventive factor for developing rheumatoid arthritis: A dose-response meta-analysis of prospective studies Annals of Rheumatic Diseases, October 24, 2014    Evidence Based Medicine    Clinical Article

13 Cost-utility of cognitive behavioural therapy versus U.S. food and drug administration recommended drugs and usual care in the treatment of patients with fibromyalgia: An economic evaluation alongside a 6-month randomised controlled trial Arthritis Research & Therapy, October 7, 2014    Clinical Article

14 Baseline serum level of matrix metalloproteinase-3 as a biomarker of progressive joint damage in rheumatoid arthritis patients International Journal of Rheumatic Diseases, October 17, 2014    Clinical Article

15 Targeted treatment with a combination of traditional DMARDs produces excellent clinical and radiographic long-term outcomes in early rheumatoid arthritis regardless of initial infliximab: The 5-year follow-up results of a randomised clinical trial, the NEO-RACo trial Annals of Rheumatic Diseases, October 23, 2014    Clinical Article

16 Low-dose pulse cyclophosphamide in interstitial lung disease associated with systemic sclerosis (SSc-ILD) - efficacy of maintenance immunosuppression in responders and non-responders Seminars in Arthritis and Rheumatism, September 30, 2014    Clinical Article

17 Vitamin D deficiency is associated with progression of knee osteoarthritis The Journal of Nutrition, October 10, 2014    Clinical Article

18 Oral bisphosphonate use and total knee/hip implant survival: Validation of results in an external population-based cohort Arthritis & Rheumatism, August 14, 2014    Clinical Article

19 Lipid profile changes in patients with chronic inflammatory arthritis treated with biologics and tofacitinib in randomized clinical trials: A systematic review and meta-analysis Arthritis & Rheumatism, October 14, 2014    Evidence Based Medicine    Review Article

20 Efficacy of a natural mineral complex in North American adults with osteoarthritis of the knee: A randomized double-blind placebo-controlled study Full Text Open Access Rheumatology: Research and Reviews, October 13, 2014    Free full text    Clinical Article

Indexed Journals in Rheumatology: Arthritis & Rheumatism, Annals of Rheumatic Diseases, Journal of Rheumatologymore