Hypothalamic-pituitary-adrenal axis function in patients with rheumatoid arthritis treated with different glucocorticoid approaches.

摘要: Glucocorticoids (GCs) continue to be an important treatment option in rheumatoid arthritis (RA) - despite their multitude of side effects. Amongst those, suppression the hypothalamic-pituitary-adrenal (HPA) axis plays a dominant role. In clinical practice, low-dose GC therapy 5 mg or less per day seems safest eschewing these undesirable effects and assuring function HPA axis. Further research has shown that, apart from dosage, degree by exogenous GCs is not only dependent on duration therapy, but that it also underlies significant diurnal variation. The recent development novel modified-release (MR) prednisone formula reflects attempt at targeting circadian neuroendocrine pathways axis' interplay with immune system RA. Data subset 28 patients included CAPRA-1 study indicated chronotherapy MR no adverse effect function. Whether adapting pathophysiological pattern might even beneficial will have further investigated.