Release date: August 2010

Expiration date: August 2011

Estimated time to complete activity: 15 minutes

Target Audience

This activity has been designed to meet the educational needs of physicians involved in the diagnosis and management of rheumatoid disease.

Program Overview

NSAIDS, novel biologics and glucocorticoids are frequently prescribed in the treatment of Rheumatoid Arthritis, although the optimal treatment regimen is evolving as new data come to light. Glucocorticoids (GCs) have a pivotal role in the pharmacologic management of Rheumatoid Arthritis (RA) and other conditions, due to their anti-inflammatory and immunosuppressive properties. In recent years, the use of low-dose GCs (below 7.5mg/day) has become an accepted treatment paradigm in order to minimize steroid side effects. Based on high-quality evidence, low-dose chronotherapy with modified-release (MR) prednisone has demonstrated superior efficacy, compared with conventional prednisone treatment, thereby further improving the benefit-risk ratio of GC therapy. The MR tablet is taken at bedtime and releases prednisone four hours after ingestion. GC release is therefore synchronized to the circadian rhythms of the disease. The improved efficacy of prednisone chronotherapy permitted effective treatment with a very low-dose of prednisone. The resulting favorable safety profile was almost comparable to placebo. It appears that MR prednisone, at low doses, is a safe and effective treatment option for the management of active RA. This activity discusses circadian release of endogenous glucocorticoids and how effective utilization of low-dose oral corticosteroids can safely and effectively provide around-the-clock anti-inflammatory benefits for RA patients.

Educational Objectives

After completing this activity, the participant should be better able to:

• Consider re-evaluation of glucocorticoids in the use of early and longstanding RA
• Recognize suboptimal or refractory responses to pharmacologic interventions and modify treatment plans accordingly

Faculty

Maurizio Cutolo, MD
Professor of Rheumatology;
Director, Research Laboratory;
Academic Unit of Clinical Rheumatology and
Postgraduate School of Rheumatology,
University of Genova,
Genova, Italy

Prof. Johannes Bijlsma
Director of Rheumatology
University Medical Center
Utrecht, The Netherlands

Prof. Frank Buttgereit
Deputy Head, Department of Rheumatology
Charité University Hospital,
Berlin, Germany

Accreditation Statement/Joint Sponsorship Statement

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Omnia Education and BetterCME. Omnia Education is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation

Omnia Education designates this educational activity for a maximum of .25 AMA PRA Category 1 Credit