Efficacy and safety of 10 mg versus 30 mg of oral prednisolone for acute CPP crystal arthritis: findings of a randomized controlled trial.

Autor: Leelasattakul W; Rheumatology Division, Department of Internal Medicine, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand., Pongsittisak W; Nephrology and Renal Replacement Therapy Division, Department of Internal Medicine, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand., Manavathongchai S; Rheumatology Division, Department of Internal Medicine, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand., Satpanich P; Rheumatology Division, Department of Internal Medicine, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand. satpanichp@gmail.com.
Jazyk: angličtina
Zdroj: Clinical rheumatology [Clin Rheumatol] 2024 Dec; Vol. 43 (12), pp. 3879-3888. Date of Electronic Publication: 2024 Oct 16.
DOI: 10.1007/s10067-024-07184-z
Abstrakt: Introduction: The optimal prednisolone dose for managing acute calcium pyrophosphate (CPP) crystal arthritis remains unclear. We compared the efficacy and safety of 10- and 30-mg daily doses of prednisolone for acute CPP crystal arthritis.
Method: This randomized, controlled, open-label trial included patients with acute CPP crystal arthritis and symptoms that had begun less than 72 h earlier. Patients without CPP crystals, those with septic arthritis, and those with uncontrolled infections were excluded. Participants received either 10 or 30 mg of prednisolone daily for 7 days. The primary outcome was time until complete resolution of symptoms; secondary outcomes included time until clinical resolution, recurrence rates, laboratory profiles, and adverse events, adjusted for confounders.
Results: Seventy-nine patients participated. Baseline characteristics were comparable, except that the 30-mg recipients had more initial inpatient visits (p = 0.03). The median time until complete resolution was 7 days in both groups (p = 0.73). The 30-mg recipients exhibited faster clinical resolution (1 vs. 3 days; p = 0.03), but adjusted analyses revealed no significant differences in time until complete resolution (6.2 vs. 6.5 days; p = 0.68) or clinical resolution (2.4 vs. 2 days; p = 0.27). The overall recurrence rate was 14.3%; the 30-mg recipients experienced slightly more recurrences (p = 0.08). The other secondary outcomes did not differ significantly.
Conclusions: The 10- and 30-mg daily doses of prednisolone were equally effective in treating acute symptoms of CPP crystal arthritis, with no significant differences in resolution time, recurrence rates, or safety outcomes.
Competing Interests: Declarations. Conflicting Interests: The authors declare no potential conflicts of interest in response to the research, authorship, and/or publication of this article.
(© 2024. The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR).)
Databáze: MEDLINE
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