Zirkadiane versus ultradiane Glukokortikoid-Gabe bei der rheumatoiden Arthritis
| Autor: | G. Döring, M. Nolte, R. Alten, K. von Werder |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
endocrine system
medicine.medical_specialty business.industry medicine.disease Regimen Endocrinology Rheumatology Rheumatoid arthritis Internal medicine medicine Prednisolone Circadian rhythm Clinical efficacy business hormones hormone substitutes and hormone antagonists Glucocorticoid Ultradian rhythm medicine.drug Hormone |
| Zdroj: | Aktuelle Rheumatologie. 34:363-369 |
| ISSN: | 1438-9940 0341-051X |
| Popis: | BACKGROUND: Since the mid 70s most rheumatologists prefer a circadian administration regimen with one morning dose of glucocorticoids (GC) in the treatment of rheumatoid arthritis (RA). It is not known whether an ultradian regimen with administration intervals of less than 24 h will yield better therapeutic results, but will probably cause a more pronounced suppression of the hypothalamus-pituitary-adrenal (HPA) axis. This open question was the objective for this monocentric, randomised, single-blind study. PATIENTS AND METHODS: 60 patients with active RA were treated with prednisolone given either in a circadian or an ultradian regimen. Treatments started with a daily dose of 40 mg which was down-titrated over 40 days to 5 mg. Before and after treatments with prednisolone, the HPA axis function was tested by corticotropin-releasing hormone (CRH) tests. RESULTS: Clinical efficacy and safety were found to be comparable for both schemes. Cortisol concentrations after the CRH tests revealed a slightly more pronounced suppression of the HPA axis function (p=0.07) in the ultradian treatment group of patients. CONCLUSIONS: In general, concerning efficacy as well as safety, our study supports a circadian administration of GC in the treatment of RA. |
| Databáze: | OpenAIRE |
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