Objectives This study was performed to determine the effects of low dose prednisolone in treatment of rheumatoid arthritis (RA), administered in the morning or at night.
Methods Thirty patients with active RA are divided randomly into two groups. For 6 months, a dosage of 7.5 mg/day prednisolone was administered at 02:00 am or 07:30 am to group I and group II respectively. In both groups, evaluations are performed between 07:30 – 08:00 am. During the treatment, changes observed each month in clinical and laboratory status of patients in both groups were recorded and results were compared both within and between the groups.
Results Significant improvements were observed in both groups in morning stiffness, joint pain, Ritchie articular index, serum CRP and ESR levels compared to values before treatment, beginning from first month to sixth month (p < 0.001). In the functional assessment; significant improvements were observed in both, determined beginning from the first month to sixth month compared to before treatment both in group receiving a night dose prednisolone and morning dose prednisolone (p < 0.05). In comparison of morning stiffness, joint pain, Ritchie articular index and its functional assessment, and serum CRP and ESR levels in both groups, no significant difference was obtained from first month to sixth month (p > 0.05).
Conclusion Low dose prednisolone therapy in treatment of RA significantly suppresses the activity of disease beginning from the first month. This condition is kept until the sixth month. However, administration of the medication either given at morning hours classically or at night according to the diurnal rhythym of disease activity doesn?t affect the results of the treatment.