From the Research
The prednisone protocol for subacute thyroiditis should start with 30 mg/day for 1 week, followed by 1 week of nonsteroidal anti-inflammatory drugs, as this regimen has been shown to have similar efficacy and recurrence rates compared to the conventional 6-week prednisone therapy, with fewer side effects 1.
Key Considerations
- The treatment goal is to use the lowest effective dose for the shortest duration possible to control symptoms while the condition resolves naturally.
- Corticosteroid therapy is generally reserved for patients with moderate to severe pain who have not responded adequately to NSAIDs or beta-blockers.
- When initiating prednisone, it's essential to monitor for potential side effects, including hyperglycemia, mood changes, insomnia, and increased susceptibility to infections.
- Patients should take the medication with food to minimize gastrointestinal irritation.
Protocol Details
- The initial dose of 30 mg/day for 1 week can be followed by 1 week of nonsteroidal anti-inflammatory drugs, as supported by the study 1.
- For severe cases, some clinicians may consider alternative regimens, but the evidence suggests that the shorter protocol is effective and has a better safety profile.
- The study 1 demonstrated that efficacy and recurrence rates were not significantly different between the short-term and conventional 6-week prednisone therapy groups.
Supporting Evidence
- A randomized controlled trial published in 2020 1 compared short-term prednisone treatment with conventional 6-week therapy and found similar outcomes with fewer side effects in the short-term group.
- Other studies, such as 2, 3, 4, and 5, provide additional context and support for the use of prednisone in subacute thyroiditis, but the most recent and highest-quality study 1 guides the recommended protocol.