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Efficacy and safety of 10 mg versus 30 mg of oral prednisolone for acute CPP crystal arthritis: findings of a randomized controlled trial
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Efficacy and safety of 10 mg versus 30 mg of oral prednisolone for acute CPP crystal arthritis: findings of a randomized controlled trial
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Efficacy and safety of 10 mg versus 30 mg of oral prednisolone for acute CPP crystal arthritis: findings of a randomized controlled trial
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Journal Article
Efficacy and safety of 10 mg versus 30 mg of oral prednisolone for acute CPP crystal arthritis: findings of a randomized controlled trial
2024
Overview
IntroductionThe 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.MethodThis 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.ResultsSeventy-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.ConclusionsThe 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.Key Points• A randomized controlled trial compared 10 mg and 30 mg daily prednisolone doses for acute CPP crystal arthritis.• Both doses resulted in similar times to complete symptom resolution and recurrence rates.• The 30-mg dose led to faster initial symptom relief, but adjusted analyses showed no significant differences.• Both doses were equally safe, with no significant differences in adverse events.
Publisher
Springer Nature B.V
Subject
