@article {Abou-Raya53, author = {Anna Abou-Raya and Suzan Abou-Raya and Tarek Khadrawi and Madihah Helmii}, title = {Effect of Low-dose Oral Prednisolone on Symptoms and Systemic Inflammation in Older Adults with Moderate to Severe Knee Osteoarthritis: A Randomized Placebo-controlled Trial}, volume = {41}, number = {1}, pages = {53--59}, year = {2014}, doi = {10.3899/jrheum.130199}, publisher = {The Journal of Rheumatology}, abstract = {Objective. To investigate the efficacy of 6 weeks of daily low-dose oral prednisolone in improving pain, mobility, and systemic low-grade inflammation in the short term and whether the effect would be sustained at 12 weeks in older adults with moderate to severe knee osteoarthritis (OA). Methods. A total of 125 patients with primary knee OA were randomized 1:1; 63 received 7.5 mg/day of prednisolone and 62 received placebo for 6 weeks. Outcome measures included pain reduction and improvement in function scores and systemic inflammation markers. Pain was assessed using the visual analog pain scale (0{\textendash}100 mm). Secondary outcome measures included the Western Ontario and McMaster Universities Osteoarthritis Index scores, patient global assessment (PGA) of the severity of knee OA, and 6-min walk distance (6MWD). Serum levels of interleukin 1 (IL-1), IL-6, tumor necrosis factor (TNF)-α, and high-sensitivity C-reactive protein (hsCRP) were measured. Results. There was a clinically relevant reduction in the intervention group compared to the placebo group for knee pain, physical function, PGA, and 6MWD at 6 weeks. The mean difference between treatment arms (95\% CI) was 10.9 (4.8{\textendash}18.0), p \< 0.001; 9.5 (3.7{\textendash}15.4), p \< 0.05; 15.7 (5.3{\textendash}26.1), p \< 0.001; and 86.9 (29.8{\textendash}144.1), p \< 0.05, respectively. Further, there was a clinically relevant reduction in the serum levels of IL-1, IL-6, TNF-α, and hsCRP at 6 weeks in the intervention group when compared to the placebo group. These differences remained significant at 12 weeks. The Outcome Measures in Rheumatology Clinical Trials-Osteoarthritis Research Society International responder rate was 65\% in the intervention group and 34\% in the placebo group (p \< 0.05). Conclusion. Low-dose oral prednisolone had both a short-term and a longer sustained effect resulting in less knee pain, better physical function, and attenuation of systemic inflammation in older patients with knee OA (ClinicalTrials.gov identifier NCT01619163).}, issn = {0315-162X}, URL = {https://www.jrheum.org/content/41/1/53}, eprint = {https://www.jrheum.org/content/41/1/53.full.pdf}, journal = {The Journal of Rheumatology} }