The efficacy of oral corticosteroids for treatment of Tietze syndrome: A pragmatic randomized controlled trial

What is known and objective Tietze syndrome is a rare form of chest wall costochondritis with joint swelling which can cause significant chest pain and decline in ability of daily activities. There is no standardized treatment protocol. The aim of this study was to assess the efficacy of adding oral...

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Bibliographic Details
Published in:Journal of clinical pharmacy and therapeutics 2022-12, Vol.47 (12), p.2279-2286
Main Authors: Elsayed, Hany Hasan, Ali, Ihab, Abdel‐Gayed, Mohammed, Warda, Aly Mohamad, Moharram, Assem Adel
Format: Article
Language:English
Subjects:
Adrenal Cortex Hormones - therapeutic use
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Chest
Chest Pain - drug therapy
Corticosteroids
costochondritis
Humans
Inflammation
Nonsteroidal anti-inflammatory drugs
Pain
Prednisolone
Prednisolone - therapeutic use
Quality of Life
Steroid hormones
Steroids
Tietze syndrome
Tietze's Syndrome - drug therapy
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Summary:What is known and objective Tietze syndrome is a rare form of chest wall costochondritis with joint swelling which can cause significant chest pain and decline in ability of daily activities. There is no standardized treatment protocol. The aim of this study was to assess the efficacy of adding oral steroids in addition to other non‐ steroidal treatment in improvement of pain and quality of life (QOL) in patients with Tietze syndrome. Methods Forty patients with Tietze syndrome were randomly divided into two treatment groups: (1) One week of prednisolone 40 mg daily followed by 1 week of prednisolone 20 mg daily followed by 1 week of 10 mg with 3 weeks of non‐steroidal anti‐inflammatory drug (NSAID) treatment (n = 20); (2) three weeks of NSAID treatment only (n = 20). A symptom questionnaire was used to rate the major symptoms of Tietze syndrome and costochondritis: Numeric rating scale (NRS) for pain on a scale of 0 (no pain) to 10 (severest pain); the resulting global symptom score was used to evaluate the efficacy of treatment with assessment of joint swelling resolution. The EQ‐5D‐5L instrument for measurement of QOL was used. Assessments were made on intention to treat basis at baseline and at 1, 2 and 3 weeks followed by a medium term follow period after treatment cessation. The trial was registered at www.isrctn.com ISRCTN11877533. Results and discussion There was a significant drop in mean NRS pain scores between the groups at 1, 2 and 3 weeks in favour of the steroid group (46.8% vs. 17.7%; p 
ISSN:0269-4727
1365-2710
DOI:10.1111/jcpt.13810