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One other important result was that patients treated with a single dose of prednisolone were statistically more likely to receive additional doses of the steroid compared to patients treated with 0.5 mg/kg prednisolone, regardless of prednisolone dose (OR 1.9, 95%CI 1.0 – 2.3). No significant difference was seen after a 1-year placebo-controlled trial when prednisolone was administered as a 0.5 or 0.8 mg dose (95%CI 0.2 – 1.7, p < 0.02), but an OR of 1.8 (1.0 – 2.4) when prednisolone was administered 1.0 mg/kg was seen when patients received both 0.5 mg and 0.8 mg doses. The researchers suggested that the finding of an increased risk of adverse effects in individuals taking prednisolone may be related to the large doses injected and the fact that prednisolone is injected orally rather than intramuscularly. In a follow--up observational study, they found that individuals treated with up to 10 mg prednisolone per day after a previous prednisolone-induced knee osteoarthritis had statistically greater reductions in non-contact joint stiffness of at least 10% (p < 0.03) compared to those treated with 1 mg of prednisolone or placebo; the difference was not statistically significant. The team's conclusions: "Our study indicates that patients with prednisolone-induced knee osteoarthritis, even when treated with a combination of prednisolone plus metformin, had statistically greater rates of clinical improvement at the end of the 3 months following steroid treatment on average than patients receiving placebo, a trend which may be explained by longer duration of treatment in the prednisolone-treated group. This finding has some important implications for clinical practice. For example, using metformin in combination with steroid may allow prednisolone to be used in combination with standard corticosteroids and NSAIDs and in some patients, the combination of corticosteroids and prednisolone may be even more beneficial than the combination of corticosteroids with prednisolone alone in reducing the frequency, severity, and the type of adverse events seen on clinical assessment following steroid use. Further clinical and laboratory studies are required to establish the clinical significance of this effect." Professor John V. McGlashan, Director of the Division of Research in the Department of Kinesiology, and President of the Medical Society of Sports in Australia Further information Please mention Similar articles: