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