SHORT-TERM VERSUS 6-WEEK PREDNISONE IN THE TREATMENT OF SUBACUTE THYROIDITIS: A RANDOMIZED CONTROLLED TRIAL

• Published in: Endocrine practice Vol. 26; no. 8; pp. 900 - 908
• Main Authors: Duan, Lian, Feng, Xiaoli, Zhang, Rui, Tan, Xiaojuan, Xiang, Xiaoyan, Shen, Rufei, Zheng, Hongting
• Format: Journal Article
• Language: English
• Published: United States Elsevier Limited 01.08.2020
• Subjects: Anemia; Antibodies; Blood pressure; Diabetes; Fever; Glucose; Hormones; Hypothyroidism; Independent sample; Lipids; Nonsteroidal anti-inflammatory drugs; Normal distribution; Patients; SAT assessment; Thyroid gland; Ulcers; Ultrasonic imaging
• ISSN: 1530-891X; 1934-2403
• DOI: 10.4158/EP-2020-0096

: Moderate-to-severe subacute thyroiditis is clinically managed with 6-8 weeks of glucocorticoid therapy. However, no studies have evaluated short-term prednisone treatment for subacute thyroiditis. : This 24-week, prospective, single-blind, randomized controlled study enrolled patients (aged 18-70) with subacute thyroiditis who were hospitalized between August 2013 and December 2014. Patients with moderate-to-severe symptoms were randomly assigned to receive either 30 mg/d prednisone for 1 week, followed by 1 week of nonsteroidal anti-inflammatory drugs, or the conventional 6-week prednisone therapy. The primary endpoint was intergroup differences in treatment efficacy at the end of treatment course. Secondary endpoints included between-group differences in post-withdrawal adverse effect parameters and thyroid function at weeks 6, 12, and 24. : We screened 96 patients, randomized 52 participants, and 50 completed the study. Efficacy and recurrence rates were not significantly different at withdrawal in both groups ( ). At treatment discontinuation, parathyroid hormone (28.8 vs 38.9 pg/mL, ) and systolic blood pressure (113.9 vs 122.4 mmHg, ) were significantly lower in the experimental group than in the control group. There were no significant intergroup differences in other secondary endpoints at withdrawal and in thyroid function at weeks 6, 12, and 24. : Fewer side effects of glucocorticoids and similar efficacy and recurrence rates were observed with short-term prednisone compared with in the 6-week treatment for subacute thyroiditis. Short-term prednisone with a better safety profile may be an alternative strategy for ameliorating moderate-to-severe symptoms of subacute thyroiditis.