Circadian variation in plasma IL-6 and the role of modified-release prednisone in polymyalgia rheumatica. (2014)

• Record Type: Journal Article
• Authors: Zakout, Samy A; Clarke, Lynsey L; Jessop, David; Straub, Rainer H; Kirwan, John R
• Is Part Of: International journal of clinical rheumatology. Volume 9:Number 5(2014)
• Page Start: 431
• Page End: 439
• Publication Date: 2014
• Subjects: chronobiology -- circadian variation cytokines -- glucocorticoids -- morning stiffness -- polymyalgia rheumatica -- treatment; Rheumatology -- Periodicals; 616.723005
• DOI: 10.2217/ijr.14.29
• Languages: English
• ISSNs: 1758-4272

Abstract

Aims: To investigate the circadian variation in IL-6 and effects of morning and night time glucocorticoids in polymyalgia rheumatica.Methods: Cytokines were measured in newly diagnosed polymyalgia rheumatica over two 24-h periods, 2 weeks apart during which they received 7 mg/day of modified-release prednisone at night or morning prednisolone. All patients then received 15 mg/day morning prednisolone. Morning IL-6 concentrations were measured after 2 weeks. Morning stiffness, changes in peak IL-6 levels and area under the curve were compared.Results: IL-6 followed a circadian rhythm with a peak at 04h00. Modified-release prednisone caused greater reduction of IL-6 and area under the curve.Conclusion: IL-6 showed marked circadian variation. The possibility that modified-release prednisone offers a treatment advantage over standard therapy should be tested in a larger study.