Although the majority of patients (82percent) and more than 87percent of rheumatologists agree that the morning stiffness and pain have an impact on quality of life of patients, almost two-thirds of rheumatologists (61percent) say that if they are not specifically treat these symptoms 0.3Complexity of the symptoms of RA, including dysfunction, physical stiffness and pain in the joints (in particular relating to the hands) can lead to difficulty in performing tasks in the morning. Lodotra (modified-release prednisone) is a treatment for moderate to severe rheumatoid arthritis, particularly those who suffer from morning stiffness. In RA increased serum levels of proinflammatory cytokines during the night are associated with joint stiffness in morning.4, 5 deregulation of the inflammatory process and the production of proinflammatory cytokines such as IL-6 were found to contribute to inflammation of the synovial membrane (the inner membrane of tissue lining a joint), while higher levels of IL-6, especially early in the morning, has been associated with morning stiffness of joints 0.4, 5.6
Taken at bedtime (around 22:00), Lodotra uses a modified-release mechanism to release low doses of prednisone 4-6 hours after ingestion, at a time in the morning, when the levels of inflammatory mediators build up.6 maximum of prednisone in the blood are reached approximately 6-9 hours after ingestion, coinciding with the moment in which the concentrations of proinflammatory cytokines such as IL-6 are in their natural peak in RA. 4,5,7 free time tonight prednisone results in a suppression marked nocturnal IL-6 and a significant reduction in the relative duration of joint stiffness on waking compared to conventional prednisone taken in the morning. 4
The survey of 750 RA patients and 518 rheumatologists in 11 countries conducted by Ipsos MORI and commissioned by Mundipharma International Limited, reveals the effect of stiffness and pain in the morning on the ability to work: 73percent of these patients in paid employment ( n = 274 report) that these symptoms have a significant impact on their work, with 96percent of patients in Poland (n = 50) and 90percent of those in Italy (n = 100) is the most affected.3, 2 Among patients in labor (n = 274), almost half (47percent) are sometimes able to work and 45percent of people who lose time from work in the last 6 months (n = 110) took over 10 days leave because of these symptoms.2
European research published today in the Annals of the Rheumatic diseases.1, 2.3 reveals the real impact of morning symptoms (RA) on the ability to work with a patient’s quality of life, with 83percent of those with severe morning stiffness (n = 170), agreeing that the difficulties caused by morning stiffness and pain control of their lives 1
1. Effect of morning stiffness and activities on the quality of life of patients with RA. Ann Rheum Dis 2011, May 2011, Abstract No. AB0674
7. Straub RH, M. Cutolo circadian rhythms in patients with rheumatoid arthritis: implications for the pathophysiology and therapeutic management. Arthritis Rheum 2007, 56: 399-408
Lodotra has been approved for the treatment of morning stiffness associated with rheumatoid arthritis and Austria, Belgium, Denmark, Finland, France, Germany, Italy, Luxembourg, Netherlands, Norway, Poland, Portugal, Sweden and the United Kingdom and is currently available in the following European countries: Austria, Belgium, Denmark, Finland, Germany, Italy, Luxembourg, Netherlands, Norway, Poland, Sweden and the United Kingdom. Studies are planned to investigate the use of modified-release prednisone in other conditions in which IL-6 plays a role.
2. Da Silva JAP, Veale D, Buttgereit. Ann Rheum Dis 2011, May 2011, Abstract No. AB0158
4. Buttgereit F, Doering G, Schaeffler A et al. Efficacy of standard for modified-release prednisone to reduce duration of morning stiffness of joints in rheumatoid arthritis (CAPRA-1): a double-blind, randomized, controlled trial.Lancet 2008, 371: 205-214
6. Wilder RL. The neuroendocrine-immune system interactions and autoimmunity. Ann Rev Immunol 1995, 13: 307-338
Lodotra is indicated for the treatment of moderate to severe active rheumatoid arthritis in adults, especially if accompanied by morning stiffness. E ‘given as a tablet that uses specially formulated for modified release technology. The active drug is contained within a core protected by a layer that acts as a barrier between the digestive fluids in the stomach. The innovative technology allows the drug to be delivered to a predetermined release rate, which in this case is four to six hours after ingestion.