EFFECTS OF TIMING OF PREDNISOLONE ON THE DURATION OF EARLY MORNING STIFFNESS, PAIN AND DISEASE ACTIVITY SCORE (DAS-28) IN PATIENTS WITH RHEUMATOID ARTHRITIS

Prednisolone in Patients With Rheumatoid Arthritis

Abstract

Objective: To determine the effects of timing of prednisolone on duration of early morning stiffness, pain score, number of swollen and tender joints, erythrocyte sedimentation rate (ESR) and disease activity score 28 (DAS-28) in joints in patients with rheumatoid arthritis.
Study Design: It was quasi experimental study.
Place and Duration of Study: This study was conducted in the department of rheumatology Fauji Foundation Hospital Rawalpindi over a period of 3 months, from Dec 2015 to Feb 2016.
Material and Methods: Total sample size of 85 was calculated by using non probability consecutive sampling technique. Patients with established rheumatoid arthritis diagnosed on the basis of ACR 1987 criteria were included in the study. All these patients had a disease duration of minimum 6 months and were on disease modifying anti rheumatic drugs and were taking ≤7.5mg of prednisolone and these patients were treated with the same dose of prednisolone given in morning at 8:00 A.M. for the first 15 days followed by treatment with same single daily dose of prednisolone given at the night 10:00 P.M. for next 15 days. This study compared duration of early morning stiffness, pain scores, number of swollen and tender joints, DAS-28 and ESR on day 15th and day 30th.
Results: A total of 85 patients of established rheumatoid arthritis were included in the study. All patients were female with a mean duration of disease of 7.87 ± 6.41 years. The mean age of patients was 49.39 ± 10.24 years. Mean of pain score, duration of morning stiffness, DAS-28, number of tender and swollen joint count, and ESR was decreased in patients who took prednisolone at 10:00 pm and had significant statistical difference (p-value<0.001).
Conclusions: Administration of low dose of prednisolone at night has good effects on duration of early morning stiffness, pain scores, number of swollen and tender joints, ESR and DAS-28.