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ISRN Pharmacology
Volume 2012, Article ID 637204, 5 pages
Research Article

Bedtime Single-Dose Prednisolone in Clinically Stable Rheumatoid Arthritis Patients

1Department of Internal Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2Department of Pharmacology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

Received 26 August 2011; Accepted 22 December 2011

Academic Editors: T. Hirano, J. C. Laguna, and T. W. Stone

Copyright © 2012 Owlia Mohammad Bagher et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Introduction. Sign and symptoms of rheumatoid arthritis have circadian rhythms and are more prominent in the morning. Timing of glucocorticoid administration may be important with respect to the natural secretion of endogenous glucocorticoids. Herein, we intended to test the hypothesis that bedtime administration of prednisolone could be more efficient in controlling signs and symptoms in patients with RA. Material and Methods. Sixty patients with stable disease were treated with single dose prednisolone at 8 a.m. for the first three months and thereafter with similar dose at 10 PM for the next three months (before-after method). We compared fatigue scores, morning stiffness and pain scores, Clinical Disease Activity Indices, erythrocyte sedimentation rates, C Reactive Protein, and profile of adverse effects. Results. The mean of morning stiffness, fatigue scores, CRP and CDAI decreased statistically when prednisolone was administrated at 10 p.m. The means of pain scores and ESR were also decreased when the patients took prednisolone at night, without significant statistical difference. Conclusion. Administration of low-dose oral prednisolone could reduce disease activity scores in morning in clinically stable patients with RA. So it could be supposed that administrating bedtime prednisolone may permit the smallest possible dose.