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Chronotherapy with Glucorticoids in Rheumatoid Arthritis

Frank Buttgereit, MD  |  Issue: January 2011  |  January 17, 2011

Although mainstays in the treatment of RA for over 60 years, glucocorticoids remain both friends and enemies and are surprisingly poorly understood. Can chronotherapy make these venerable agents more friendly? The answer to this question is obvious: Only time will tell.

Dr. Buttgereit is professor of rheumatology and clinical immunology at Charité University Medicine Berlin, Germany.

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References

  1. Buttgereit F, Wehling M, Burmester G. A new hypothesis of modular glucocorticoid actions: Steroid treatment of rheumatic diseases revisited. Arthritis Rheum. 1998;41: 761-767.
  2. Buttgereit F, Straub RH, Wehling M, Burmester GR. Glucocorticoids in the treatment of rheumatic diseases: An update on the mechanisms of action. Arthritis Rheum. 2004;50:3408-3417.
  3. Rhen T, Cidlowski JA. Antiinflammatory action of glucocorticoids—new mechanisms for old drugs. N Engl J Med. 2005;353:1711-1723.
  4. Croxtall JD, Choudhury Q, Flower RJ. Glucocorticoids act within minutes to inhibit recruitment of signalling factors to activated EGF receptors through a receptor-dependent, transcription-independent mechanism. Br J Pharmacol. 2000;130:289-298.
  5. Buttgereit F, Burmester GR, Straub RH, Seibel MJ, Zhou H. Exogenous and endogenous glucocorticoids in rheumatic diseases. Arthritis Rheum. 2010 Oct 8 (Epub ahead of print).
  6. 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;65:285-293.
  7. Stahn C, Buttgereit F. Genomic and nongenomic effects of glucocorticoids. Nat Clin Pract Rheumatol. 2008;4:525-533.
  8. Zimmermann GR, Avery W, Finelli AL, Farwell M, Fraser CC, Borisy AA. Selective amplification of glucocorticoid anti-inflammatory activity through synergistic multi-target action of a combination drug. Arthritis Res Ther. 2009;11:R12.
  9. Barrera P, et al. Long-circulating liposomal prednisolone versus pulse intramuscular methylprednisolone in patients with active rheumatoid arthritis [abstract]. Proceedings of the American College of Rheumatology (ACR) Scientific Meeting; Oct 24–29, 2008; San Francisco. Hall A, poster 453, 2008.
  10. Metselaar JM, Wauben MH, Wagenaar-Hilbers JP, Boerman OC, Storm G. Complete remission of experimental arthritis by joint targeting of glucocorticoids with long-circulating liposomes. Arthritis Rheum. 2003;48:2059-2066.
  11. Rauchhaus U, Kinne RW, Pohlers D, et al. Targeted delivery of liposomal dexamethasone phosphate to the spleen provides a persistent therapeutic effect in rat antigen-induced arthritis. Ann Rheum Dis. 2009;68:1933-1934.
  12. Rauchhaus U, Schwaiger FW, Panzner S. Separating therapeutic efficacy from glucocorticoid side-effects in rodent arthritis using novel, liposomal delivery of dexamethasone phosphate: Long-term suppression of arthritis facilitates interval treatment. Arthritis Res Ther. 2009;11:R190.
  13. Buttgereit F, Doering G, Schaeffler A, et al. Efficacy of modified-release versus standard prednisone to reduce duration of morning stiffness of the joints in rheumatoid arthritis (CAPRA-1): A double-blind, randomised controlled trial. Lancet. 2008;371:205-214.
  14. 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: 894-899.
  15. Straub RH, Cutolo M. Circadian rhythms in rheumatoid arthritis: Implications for pathophysiology and therapeutic management. Arthritis Rheum. 2007;56:399-408.
  16. Cutolo, M, Masi AT. Circadian rhythms and arthritis. Rheum Dis Clin North Am. 2005; 31: 115-129, ix-x.
  17. target=”_blank”>Arvidson NG, Gudbjörnsson B, Elfman L, Rydén AC, Tötterman TH, Hällgren R. Circadian rhythm of serum interleukin-6 in rheumatoid arthritis. Ann Rheum Dis. 1994;53:521-524.
  18. Perry MG, Kirwan JR, Jessop DS, Hunt LP. Overnight variations in cortisol, interleukin 6, tumour necrosis factor alpha and other cytokines in people with rheumatoid arthritis. Ann Rheum Dis. 2009;68:63-68.
  19. Dayer JM, Choy E. Therapeutic targets in rheumatoid arthritis: The interleukin-6 receptor. Rheumatology (Oxford). 2010;49:15-24.
  20. 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;66:1560-1567.
  21. Westhoff G, Buttgereit F, Gromnica-Ihle E, Zink A. Morning stiffness and its influence on early retirement in patients with recent onset rheumatoid arthritis. Rheumatology (Oxford). 2008;47: 980-984.
  22. Buttgereit F, Doering G, Schaeffler A, et al. Targeting pathophysiological rhythms: Prednisone chronotherapy shows sustained efficacy in rheumatoid arthritis. Ann Rheum Dis. 2010;69:1275-1280.
  23. Alten R, Döring G, Cutolo M, et al. Hypothalamus-pituitary-adrenal axis function in patients with rheumatoid arthritis treated with nighttime-release prednisone. J Rheumatol. 2010; 37:2025-2031.
  24. Buttgereit F, et al. Low-dose glucocorticoid chronotherapy of rheumatoid arthritis: 12 week efficacy data of 5 mg modified-release (MR) prednisone. Ann Rheum Dis. 2010; 69(Suppl 3):220.
  25. Buttgereit F, et al. Safety data for low-dose glucocorticoid chronotherapy of rheumatoid arthritis with 5 mg modified-release (MR) prednisone in a randomized, double-blind, placebo-controlled trial. Ann Rheum Dis. 2010; 69 (Suppl 3):219.

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Filed under:ConditionsResearch RheumRheumatoid Arthritis Tagged with:DrugsglucocorticoidPathogenesisResearchRheumatoid arthritisTreatment

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