Circulating interleukin-6 as a biomarker in a randomized controlled trial of modified-release prednisone vs immediate-release prednisolone, in newly diagnosed patients with giant cell arteritis.
Administration, Oral
Aged
Biomarkers
/ blood
Delayed-Action Preparations
Dose-Response Relationship, Drug
Drug Administration Schedule
Feasibility Studies
Female
Follow-Up Studies
Giant Cell Arteritis
/ blood
Glucocorticoids
/ administration & dosage
Humans
Interleukin-6
/ blood
Male
Middle Aged
Prednisolone
/ administration & dosage
Prednisone
/ administration & dosage
Treatment Outcome
giant cell arteritis
glucocorticoids
immediate-release prednisolone
interleukin 6
modified-release prednisone
Journal
International journal of rheumatic diseases
ISSN: 1756-185X
Titre abrégé: Int J Rheum Dis
Pays: England
ID NLM: 101474930
Informations de publication
Date de publication:
Oct 2019
Oct 2019
Historique:
received:
06
03
2019
revised:
03
07
2019
accepted:
12
07
2019
pubmed:
19
9
2019
medline:
9
4
2020
entrez:
19
9
2019
Statut:
ppublish
Résumé
To measure serial interleukin (IL)-6 levels in newly diagnosed patients with giant cell arteritis (GCA), treated in a randomized controlled trial of modified-release prednisone (MR) vs immediate-release prednisolone (IR) used in a tapering regimen conforming to British Society for Rheumatology GCA guidelines. Patients (n = 12) were randomized into 2 treatment arms (7 MR, 5 IR) and followed over 26 weeks. We measured IL-6 with additional markers. A significantly higher overall mean IL-6 level (P < .05) was seen in IR (mean = 12.15, standard error [SE] = 1.90) compared with MR (mean = 4.39, SE = 1.84). Mean collagen type 1 cross-linked C-telopeptide (CTX) concentration was significantly higher (P < .05) in both groups at week 4 (mean = 0.29, SE = 0.04) compared with week 26 (mean = 0.13, SE = 0.02). MR patients had adrenocorticotropic hormone (ACTH) suppression compared with IR (P < .05) throughout without differences in cortisol levels (P = .34). No significant differences were seen between arms in other markers. Our study suggests that elevated levels of IL-6 in new GCA are better suppressed by MR prednisone compared with IR prednisolone. CTX was significantly reduced in both treatment arms indicating early metabolic effect of glucocorticoids on bone. ACTH suppression with MR prednisone may reflect a greater impact on the hypothalamic-pituitary-adrenal axis although cortisol was not affected. MR prednisone warrants further investigation in GCA.
Identifiants
pubmed: 31531960
doi: 10.1111/1756-185X.13702
doi:
Substances chimiques
Biomarkers
0
Delayed-Action Preparations
0
Glucocorticoids
0
Interleukin-6
0
Prednisolone
9PHQ9Y1OLM
Prednisone
VB0R961HZT
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
1900-1904Subventions
Organisme : Napp Pharmaceuticals Limited
Informations de copyright
© 2019 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.
Références
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GraphPad Software. GraphPad prism version 7.01 for windows 2016.