["Morning type" and "evening type" in activated osteoarthritis. Analysis and practice-related conclusions of an open,...

3,672 patients with activated osteoarthritis were treated for 20 days with daily doses of 1,800 to 2,400 mg ibuprofen (Anco). Patients experiencing the greatest pain in the morning (6-12 a.m.) or in the evening (3-9 p.m.) were grouped together as morning type and evening type, respectively and submitted to subgroup analysis. An explorative, stepwise logistic regression with the variable morning type/evening type revealed the dominant factors which, in the order given, represent the most accurate criteria for characterizing the two types to be: pain at rest at the start of the trial, localization of arthritis, and occupation. The consistency of the pain-time profile throughout the 20-day treatment period further showed that these two subgroups actually do exist and can be differentiated. A consideration of benefit/risk ratio revealed no differences between the groups and the overall population, although an advantage vis-a-vis pretreatment was observed. A therapeutic recommendation that can be derived from the findings is that, depending upon the pain-time profile, a higher doses should be given in the morning and evening, respectively, and that no medication need be given during periods with little or no pain.