Whatever is the medical problem, it's always hard to achieve the best concentration of the active ingredients of the drug in the bloodstream at the right time. This is slightly less of a treatment issue when the problem is relatively stable. Should the concentration fall too quickly, the patient can simply take more of the drug. In a hospital environment where there's continuous monitoring of the patient, this is relatively safe because there's always someone monitoring intake and ensuring there's no risk of an overdose. But once the patient leaves a supervised environment, there are two difficulties. Firstly, there is the temptation to take more medication whenever the symptoms flare. Unless this is controlled, the patient is more likely to experience side effects, builds up tolerance too quickly, and may overdose. Secondly, it goes for the patient's need to sleep. Even though the sleep may be disturbed, it's a vital part of the recovery process. Waking the patient up during the night to take medication is not recommended. This has led to the development of sustained or modified-release delivery systems.
The idea is very simple. Based on the knowledge the body filters the active ingredient of the drug out of the bloodstream over time, capsules releasing the drug at a steady rate over a specific period of time maintain the concentration with a significantly reduced risk of side effects. There's a secondary question. Some medical conditions have a daily cycle where the symptoms vary in a predictable way. It's more convenient to take a capsule which delays releasing the drug until it's most needed by the body. This is particularly useful for taking drugs overnight. You don't have to wake up a patient any more - he or she can take a pill that will release the drug at predetermined time during sleep.
It's a great solution for a condition like rheumatoid arthritis which leads to morning stiffness and increased pain on waking. New research from Italy confirms modified release Prednisone is better than the low dose immediate-release form. The study involved nine-hundred-fifty participants with an average age of 57. Over a period of four months, the participants were changed from the immediate to the modified-release form. Some 97% showed significantly improved mobility on waking and reported less pain. Anyways, that doesn't mean that everyone will benefit. We are at an intermediate stage in the research. This Italian study is one of an increasing number of short-term studies, all of which confirm promise in the switch of format. We still don't have any long-term studies lasting for not less than one year. Prednisone has proved to be remarkably effective in the treatment of rheumatoid arthritis, but there's no data on how the body reacts to a spike in the drug about one hour before the usual waking time. Hopefully no adverse effects will be detected and everyone can benefit from this development.