Does high hepatic bioavailability enhance the effect of oral compared to subcutaneous glucocorticoids?
Authors' conclusion
Short-term oral low-dose GC therapy is not more effective than parental GC in decreasing ESR, arguing against therapeutic high hepatic bioavailability effects.
Study context
- Population
- Patients with RA or PsA, elevated erythrocyte sedimentation rate (ESR) (≥30 mm/h) and no current or recent glucocorticoids (GC) therapycrossover
- Participants
- 10 patients
- Comparison
- Oral vs subcutaneous low-dose prednisolone 5 mg/day for 4 days
- Primary endpoint
- Change in ESR after each treatment course
Methodological detailsnon-blinded, crossover, 10-day washout, Pilot study (n=5): 5 mg/day oral prednisolone decreased ESR significantly, informing sample size of 10
- Non-blinded
- Crossover
- 10-day washout
- Pilot study (n=5): 5 mg/day oral prednisolone decreased ESR significantly, informing sample size of 10
Primary result
As reported in the abstract
Change in ESR
Oral
−5.6
SD 20.9 · mm/h
Subcutaneous
−5.8
SD 3.0 · mm/h
P = 0.98
Further findings
- The treatment order had no effect on the outcome
Original publication
Does high hepatic bioavailability enhance the effect of oral compared to subcutaneous glucocorticoids? Clin Exp Rheumatol. Published 1 March 2024. doi:10.
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