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Are modified-release corticosteroids good therapeutic options for patients with RA?

机译:缓释皮质类固醇激素对RA患者是否有良好的治疗选择?

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Glucocorticoids have good efficacy as anti-inflammatory agents but are associated with adverse effects. Buttgereit et al. have compared the efficacy of modified-release prednisone with that of standard, immediate-release prednisone for the treatment of rheumatoid arthritis. The modified-release tablets are designed to liberate the glucocorticoid approximately 4 h after ingestion, and can be taken at bedtime so that the prednisone release coincides with peaks in endogenous cortisol levels and symptoms of disease in the early hours of the morning. The authors of this study hypothesized that the modified release would improve the benefit-risk ratio of this glucocorticoid. The 12-week, multicenter, double-blind, randomized controlled trial included 251 patients who completed the study. In patients with active rheumatoid arthritis, prescription of the modified-release tablet for night-time ingestion resulted in a mean 29.2 min shorter duration of morning stiffness than in patients who received standard immediate-release prednisone tablets in the morning, and a total 44.0 min reduction in morning-stiffness duration at 12 weeks compared with baseline. The safety profiles of the modified-release and immediate-release forms of prednisone were similar.
机译:糖皮质激素作为抗炎药具有良好的疗效,但与不良反应有关。 Buttgereit等。已将缓释泼尼松与标准速释泼尼松治疗类风湿性关节炎的疗效进行了比较。缓释片剂的设计目的是在摄入后约4小时释放糖皮质激素,并且可以在就寝时间服用,以使泼尼松的释放与清晨内源性皮质醇水平的峰值和疾病症状重合。这项研究的作者假设改良释放将改善这种糖皮质激素的获益风险比。这项为期12周的多中心,双盲,随机对照试验包括251位完成研究的患者。在活动性类风湿关节炎患者中,夜间服用处方缓释片比早晨接受标准泼尼松片的患者平均早僵硬时间平均缩短了29.2分钟,而总时间为44.0分钟与基线相比,第12周的早晨僵硬持续时间减少。泼尼松的改良释放和立即释放形式的安全性相似。

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