Synthetic
corticosteroids are widely used due to their anti-inflammatory and
immunosuppressant effects. Their use has been associated with
venous thromboembolism, but it is unknown whether
thromboembolism has a causal relationship with
corticosteroid treatment. In a randomised, double-blind, placebo-controlled trial in normal to
overweight healthy men, the effect of the
corticosteroid prednisolone on haemostasis using either 50 mg
prednisolone or matching placebo once daily for ten days was investigated. The primary outcome was a change from baseline in the viscoelastic measurement maximal amplitude of clot in
kaolin-activated thromboelastography (TEG). Changes from baseline in other TEG measurements,
D-dimer,
von Willebrand factor (VWF)
antigen, and
ristocetin cofactor activity (RCo),
antithrombin,
protein C,
prothrombin,
fibrinogen, INR, APTT, and platelet count were secondary outcomes. Thirty-four men participated in this study. Compared to placebo,
prednisolone treatment did not affect maximal amplitude of clot (difference -0.77 (95% confidence interval (CI) -2.48, 0.94) mm, p = 0.37, missing: n = 2), but it altered VWF
antigen (28%, p = 0.0004), VWF:RCo (19%, p = 0.0006),
prothrombin (5%, p = 0.05),
protein C (31%, p < 0.0001),
antithrombin (5%, p = 0.013), and
fibrinogen (-15%, p = 0.004). Thus,
prednisolone treatment did not alter TEG-assessed maximal amplitude of clot, despite that it affected prothrombotic markers (increased
prothrombin, VWF
antigen, VWF:RCo,
prothrombin, and decreased
fibrinogen) and increased antithrombotic markers (
protein C and
antithrombin).