Rheumatoid arthritis is one of the more unpleasant of the non-fatal diseases because it produces a painful condition and there’s no long-term cure. This leads to both physical incapacity and depression. It’s difficult to stay positive when you know there’s no end in sight. This puts pressure on the medical researchers to come up with ways in which the quality of life can be improved. One of the more common difficulties is the stiffness that affects everyone when they wake. There are two factors contributing to this phenomenon. The first is the slow build-up of inflammation overnight. Given that Prednisone is one of the standard treatments to relieve inflammation, the research has focused on how to get the best results. The second is the lack of physical mobility during sleep. Even though it’s often quite painful to move around, the more you exercise, the greater the degree of mobility you will enjoy. The less you move, the more stiff you will become.
The CAPRA-1 trial compared the results of taking an immediate-release Prednisone tablet on waking, and using a modified-release tablet to delay the release of the active chemicals into the bloodstream for four hours. The idea under test was whether matching the deployment of the drug to the circadian rhythms of the body gave a better outcome. This way, if you sleep for about seven hours, the drug will be at maximum effectiveness when you are due to wake.
This was a twelve week, double-blind trial with almost 300 participants and the results confirm the delayed release of Prednisone was convenient and more effective, allowing patients to move with relative freedom immediately they awoke. Although the immediate-release format did allow the joints to begin moving reasonably quickly, there was still that initial period of stiffness to deal with. Since there was no difference in the incidence of side effects between the two formats of tablet, the researchers concluded people who experience morning stiffness would benefit from switching over to the delayed-release format. If in doubt, talk to your regular physician about whether this is likely to help you.