COMMON USES
CHRONOTHERAPY
PATIENT IDENTIFIER

COMMON USES

Glucocorticoids, such as prednisone, are commonly used for treating a wide range of both acute and chronic inflammatory conditions due to their powerful anti-inflammatory effects1,4,5


WHEN USING AS LONG-TERM MAINTENANCE, TREATING WITH LOWER DOSES CAN HELP REDUCE THE RISK OF THE UNDESIRABLE EFFECTS ASSOCIATED WITH HIGHER DOSES OF PREDNISONE.1,6

THE RISKS OF ADVERSE EVENTS WITH LONG-TERM PREDNISONE USE:

  • CAN BE DOSE-RELATED AND PATIENT-SPECIFIC7
    patient-specfic
  • HAVE BEEN SHOWN TO BE LOWEST WITH DOSES LESS THAN 5 MG PER DAY8
    doses
  • MAY BE PREVENTED OR TREATED, SO CAREFUL MONITORING TO DETECT THEM IS IMPORTANT4
    detect

COMMON ADVERSE EVENTS WITH PREDNISONE

  • Fluid retention
  • Alteration in glucose tolerance
  • Elevation in blood pressure
  • Behavioral and mood changes
  • Increased appetite
  • Weight gain

MONITOR PATIENTS REGULARLY, SEEKING TITRATION OPPORTUNITIES TO LOWER PREDNISONE DOSAGES

CHRONOTHERAPY

IT IS WELL ESTABLISHED THAT SYMPTOMS OF CERTAIN CHRONIC INFLAMMATORY CONDITIONS, SUCH AS RA, FOLLOW A CIRCADIAN RHYTHM9,10

  • Circadian variations in clinical symptoms correspond with altered concentrations of inflammatory mediators, as well as melatonin and cortisol11
  • Symptoms for RA and certain inflammatory conditions are commonly worse for patients when waking up in the morning and are preceded by elevated levels of inflammatory activity2,3,12,13

Chronotherapy—timing the dose of medication to coincide with the nocturnal rise in inflammatory mediators—may be an effective approach to treating inflammatory symptoms that are more severe in the morning2,3

Note: Clinical studies of RAYOS have been conducted for rheumatoid arthritis (RA) only.

PATIENT IDENTIFIER

COULD PREDNISONE HELP YOUR PATIENTS FIND RELIEF?

Patients with RA or certain inflammatory conditions may benefit from long-term maintenance of low-dose prednisone to help control disease activity and inflammation.4,6,15

Select the following that apply to the patients you see in your practice to see if prednisone may be appropriate for them:

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SEE IF PREDNISONE MAY BE AN OPTION FOR YOUR PATIENTS

CONSIDER TAKING A CHRONOTHERAPEUTIC APPROACH WITH PREDNISONE FOR APPROPRIATE PATIENTS

PREDNISONE MAY BE APPROPRIATE AS PART OF YOUR PATIENTS’ TREATMENT PLANS

CONSIDER PREDNISONE FOR YOUR PATIENTS WHO REQUIRE RELIEF FROM CHRONIC PAIN AND INFLAMMATION

WHAT PERCENTAGE OF YOUR PATIENTS ARE TREATED WITH PREDNISONE TO RELIEVE PAIN DUE TO AN INFLAMMATORY CONDITION?

Drag the slider across to reach your response.

  • 0-25%
  • 26-50%
  • 51-75%
  • 76-100%

Is it time to take a chronotherapeutic approach for your patients with RA?

Consider if delayed-release prednisone may be appropriate for your patients.

SEE HOW IT WORKS
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  • Buttgereit F, Burmester GR, Lipworth BJ. Optimised glucocorticoid therapy: the sharpening of an old spear. Lancet. 2005;365(9461):801-803.
  • Spies CM, Straub RH, Cutolo M, Buttgereit F. Circadian rhythms in rheumatology–a glucocorticoid perspective. Arthritis Res Ther. 2014;16(Suppl 2):S3.
  • Cutolo M. Chronobiology and the treatment of rheumatoid arthritis. Curr Opin Rheumatol. 2012;24(3):312-318.
  • van der Goes MC, Jacobs JW, Boers M, et al. Monitoring adverse events of low-dose glucocorticoid therapy: EULAR recommendations for clinical trials and daily practice. Ann Rheum Dis. 2010;69(11):1913-1919.
  • RAYOS (prednisone) delayed-release tablets [prescribing information] Horizon.
  • Da Silva JA, Jacobs JW, Kirwan JR, et al. Safety of low dose glucocorticoid treatment in rheumatoid arthritis: published evidence and prospective trial data. Ann Rheum Dis. 2006;65(3):285-293.
  • Strehl C, Bijlsma JWJ, de Wit M, et al. Defining conditions where long-term glucocorticoid treatment has an acceptably low level of harm to facilitate implementation of existing recommendations: viewpoints from an EULAR task force. Ann Rheum Dis. 2016;75(6):952-957.
  • Saag KG, Koehnke R, Caldwell JR, et al. Low dose long-term corticosteroid therapy in rheumatoid arthritis: an analysis of serious adverse events. Am J Med. 1994;96(2):115-123.
  • Spies CM, Cutolo M, Straub RH, Burmester GR, Buttgereit F. More night than day—circadian rhythms in polymyalgia rheumatica and ankylosing spondylitis. J Rheumatol. 2010;37(5):894-899.
  • Buttgereit F, Mehta D, Kirwan J, et al. Low dose prednisone chronotherapy for rheumatoid arthritis: a randomized clinical trial (CAPRA-2). Ann Rheum Dis. 2013;72(2):204-210.
  • Cutolo M, Hopp M, Liebscher S, Dasgupta B, Buttgereit F. Modified-release prednisone for polymyalgia rheumatica: a multicentre, randomised, active-controlled, double-blind, parallel-group study. RMD Open. 2017;3(1):e000426.
  • Galbo H, Kall L. Circadian variations in clinical symptoms and concentrations of inflammatory cytokines, melatonin, and cortisol in polymyalgia rheumatica before and during prednisolone treatment: a controlled, observational, clinical experimental study. Arthritis Res Ther. 2016;18(1):174.
  • Cutolo M, Masi AT. Circadian rhythms and arthritis. Rheum Dis Clin North Am. 2005;31(1):115-129.
  • Ohdo S. Chronotherapeutic strategy: rhythm monitoring, manipulation and disruption. Adv Drug Deliv Rev. 2010;62(9-10):859-875.
  • Hoes JN, Jacobs JW, Boers M, et al. EULAR evidence-based recommendations on the management of systemic glucocorticoid therapy in rheumatic diseases. Ann Rheum Dis. 2007;66(12):1560-1567.