Efficacy of Lodotra®(Prednisone) in Reduction of Morning Stiffness Duration(K-IMPROvE)
Condition: Rheumatoid Arthritis
MeSH terms: Arthritis; Arthritis, Rheumatoid
Intervention: Lodotra®
Intervention description: Single arm will be received below oral 10mg tablet daily and maximum 10mg/d depending on the clinical symptoms and the patient's response
Intervention MeSH terms: Prednisone
Phase: Phase 4
Study type: Interventional
Primary purpose: Treatment
Intervention model: Single Group Assignment
Masking: None (Open Label)
Enrollment: 147.0
Sex: All
Minimum age: 20 Years
Maximum age: 80 Years
Healthy volunteers: No
Keywords: RA, MS, Safety, Efficacy, MR prednisone

Summary:

      This study is multicenter, Ph IV, single arm, interventional study to assess relative
      reduction of morning stiffness of Lodotra® in Rheumatoid Arthritis patients.Study medication
      will start after study visit at baseline (week 0, visit 1) and follow-up visit will be after
      2, 6 and 12 weeks after treatment (visit 2,3,4).
    

Eligibility criteria:

        Inclusion Criteria:

          -  Patients who are diagnosed more than 3 months

          -  Morning stiffness on previous treatment with or without oral steroids (below or equal
             to 10mg per day, methylprednisolone doses were converted into prednisone doses as
             follows: prednisone dosed=methylprednisolone dose*1.25), average daily duration of 45
             min or more.

          -  Average daily maximum pain intensity score (100 mm VAS) of 30mm or more.

          -  DAS-ESR ≥3.2

          -  On DMARD treatment including MTX for ≥3months and stable treatment dose within the
             past 30 days. There are no limitations on number of DMARDs treatment.(Except patients
             who have experience of adverse drug reaction of MTX or difficulty to administer MTX
             due to disease specific condition.)

          -  Able to perform study procedures and given written informed consent.

          -  Naïve patients with Prednisone MR(Lodotra® ) or patients not treat with Prednisone
             MR(Lodotra®) within 4 weeks(28days)

          -  Subject who keeps to administer study drug at 22±30 daily

          -  Subject who provide signed and dated written voluntary informed consent

        Exclusion Criteria:

          -  Patients who suffers from another disease, which requires glucocorticoid treatment
             during the study period.

          -  Synovectomy within 4 months prior to study start.

          -  Patients who underwent joint injections on only fingers and wrists(both sides) within
             4 weeks prior to first visit. Clinically significant disease which, in the
             investigator's opinion, would exclude the subject from the study.

          -  Significant renal impairment (serum creatinine>2.0mg/dl)

          -  Significant hepatic impairment (>3 times the upper limit of normal range in each site)

          -  All contra-indications for glucocorticoids.(established new osteoporotic fractures
             history of corticoid psychosis, herpes simplex and herpes zoster, varicella infection)

          -  Uncontrolled DM(HbA1c>8.0)

          -  Women of child-bearing potential, defined as all women physiologically capable of
             becoming pregnant. UNLESS they are:

               -  women whose career, lifestyle, or sexual orientation precludes intercourse with a
                  male partner

               -  women whose partners have been sterilized by vasectomy or other means

               -  two birth control methods. The two methods can be a double barrier method or a
                  barrier method plus a hormonal method. Adequate barrier methods of contraception
                  include: diaphragm, condom (by the partner), intrauterine device (copper or
                  hormonal), sponge or spermicide. Hormonal contraceptives include any marketed
                  contraceptive agent that includes an estrogen and/or a progestational agent.

          -  Pregnant or nursing (lactating) women, where pregnancy is defined as the state of a
             female after conception and until the termination of gestation, confirmed by a
             positive urine pregnancy test

          -  Participation in another clinical study within the past 30 days

          -  Known hypersensitivity to prednisone

          -  Infection patients without effective antimicrobial and systemic mycosis infection
             patients(infection might be aggravated due to suppression of immunologic function.)

          -  Patients with immunization with live vaccines within 2 weeks of enrollment or planned
             during the study

          -  Since this drug contains glucose, patients with rare hereditary problems of galactose
             intolerance, Lapp lactase deficiency or glucose-galactose malabsorption should not
             take this drug.