Abstract
Subacute thyroiditis is a transient inflammatory thyroid disease of unknown etiology. The primary goal for treatment is to mitigate inflammation. The aim of this retrospective study was to compare the therapeutic effects of prednisolone and nonsteroidal anti-inflammation drugs in patients with subacute thyroiditis. In this study, 53 consecutive Japanese patients who had been diagnosed with were referred to our hospital for further management. After excluding 11 patients (9 did not need treatment, 2 did not meet the criteria for diagnosis of subacute thyroiditis), the remaining 42 patients were treated either with prednisolone (n = 25) or loxoprofen (n = 17). We compared the time periods required for resolution of clinical symptoms and signs and normalization of thyroid function between the two groups. The mean dose of prednisolone was 15.0 (range, 14–16) mg/day and that of loxoprofen was 180 mg/day. The time period to normalization of thyroid function was comparable between the prednisolone and loxoprofen groups (25, 18–36, vs 32, 21–39 days, p = 0.388). However, the time period for resolution of symptoms was shorter under prednisolone than loxoprofen (7, 7–12 days, vs 21, 14–32 days, p < 0.001). Prednisolone treatment of patients with subacute thyroiditis was superior to nonsteroidal anti-inflammation drugs with regard to resolution of symptoms.
Similar content being viewed by others
Abbreviations
- eTV:
-
estimated thyroid volume
- FT3:
-
free triiodothyronine
- FT4:
-
free thyroxine
- NSAIDs:
-
nonsteroidal anti-inflammatory drugs
- PSL:
-
prednisolone
- SAT:
-
subacute thyroiditis
- STA-PSV:
-
mean peak systolic velocity of superior thyroid artery
- TRAb:
-
thyrotropin receptor antibody
- TSH:
-
thyrotropin
References
R.S. Bahn Chair, H.B. Burch, D.S. Cooper, J.R. Garber, M.C. Greenlee, I. Klein, P. Laurberg, I.R. McDougall, V.M. Montori, S.A. Rivkees, D.S. Ross, J.A. Sosa, M.N. Stan, Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. Thyroid 21(6), 593–646 (2011)
M. Yamamoto, S. Saito, K. Kaise, N. Kaise, K. Yoshida, K. Yoshinaga, Changes in thyroid hormones by treatment with aspirin and prednisolone in subacute thyroiditis with hyperthyroidism. Tohoku J. Exp. Med. 127(1), 85–95 (1979)
M. Yamamoto, S. Saito, T. Sakurada, H. Fukazawa, K. Yoshida, K. Kaise, N. Kaise, T. Nomura, Y. Itagaki, K. Yonemitsu, K. Yoshinaga, Effect of prednisolone and salicylate on serum thyroglobulin level in patients with subacute thyroiditis. Clin. Endocrinol. (Oxf) 27(3), 339–344 (1987)
T. Uchida, R. Suzuki, T. Kasai, H. Onose, K. Komiya, H. Goto, K. Takeno, S. Ishii, J. Sato, A. Honda, Y. Kawano, M. Himuro, E. Yamada, T. Yamada, H. Watada, Cutoff value of thyroid uptake of Tc-pertechnetate to discriminate between Graves' disease and painless thyroiditis: a single center retrospective study. Endocr. J. 63(2), 143–149 (2016)
E. Nishihara, H. Ohye, N. Amino, K. Takata, T. Arishima, T. Kudo, M. Ito, S. Kubota, S. Fukata, A. Miyauchi, Clinical characteristics of 852 patients with subacute thyroiditis before treatment. Intern. Med. 47(8), 725–729 (2008)
S. Kubota, E. Nishihara, T. Kudo, M. Ito, N. Amino, A. Miyauchi, Initial treatment with 15 mg of prednisolone daily is sufficient for most patients with subacute thyroiditis in Japan. Thyroid 23(3), 269–272 (2013)
C.A. Benbassat, D. Olchovsky, G. Tsvetov, I. Shimon, Subacute thyroiditis: clinical characteristics and treatment outcome in fifty-six consecutive patients diagnosed between 1999 and 2005. J. Endocrinol. Invest. 30(8), 631–635 (2007)
R. Volpe, The management of subacute (DeQuervain's) thyroiditis. Thyroid 3(3), 253–255 (1993)
F.M. Cunningham, P. Lees, Advances in anti-inflammatory therapy. Br. Vet. J. 150(2), 115–134 (1994)
Acknowledgments
The authors thank Noriko Iijima, Emi Ito, and Yoko Kawase for the excellent technical assistance.
Funding
This research did not receive any specific funds from public, commercial or not-for-profit funding agency in the sector.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interests.
Electronic supplementary material
Rights and permissions
About this article
Cite this article
Sato, J., Uchida, T., Komiya, K. et al. Comparison of the therapeutic effects of prednisolone and nonsteroidal anti-inflammatory drugs in patients with subacute thyroiditis. Endocrine 55, 209–214 (2017). https://doi.org/10.1007/s12020-016-1122-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12020-016-1122-3