Does adding an oral cortisone pill to the regular treatment of patients with rib cage pain and swelling improve their pain and quality of life?

ISRCTN ISRCTN11877533
DOI https://doi.org/10.1186/ISRCTN11877533
Submission date
18/04/2022
Registration date
30/04/2022
Last edited
29/11/2022
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Skin and Connective Tissue Diseases
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English Summary

Background and study aims
Tietze syndrome is a rare form of chest wall inflammation with joint swelling which can cause significant chest pain and a decline in the ability of daily activities. It can be easily confused with other serious diseases that affect the heart, lung and chest wall. It can be a frequent cause for visiting the emergency department or outpatient clinic. 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 the improvement of pain and quality of life in patients with Tietze syndrome.

Who can participate?
Patients aged 12 to 60 years old presenting with anterior or posterior chest wall swelling and/or palpable tenderness upon examination without any significant past medical history, or with history of recurrent chest infection or multiple minor chest trauma.

What does the study involve?
Participants will be randomly allocated to receive treatment as usual or an oral corticosteroid in addition to treatment as usual for 3 weeks. Follow up is for up to 12 months.

What are the possible benefits and risks of participating?
Benefits include improvement in pain and quality of life with the intervention
Risks include the adverse effects of oral corticosteroids which will be monitored by the study

Where is the study run from?
Thoracic surgery department, Ain Shams University (Egypt)

When is the study starting and how long is it expected to run for?
February 2020 to April 2022

Who is funding the study?
Investigator initiated and funded

Who is the main contact?
Prof Hany Hassan Elsayed, hanyhassan77@hotmail.com

Contact information

Prof Hany Hasan Elsayed
Principal Investigator

15 9th area buildings
sheraton heliopolis
Cairo
c236667
Egypt

ORCiD logoORCID ID 0000-0002-7597-6070
Phone +20 1227373270
Email Hany.hassan@med.asu.ed.eg

Study information

Study designSingle center randomized controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet No participant information sheet available
Scientific titleThe efficacy of oral corticosteroids for treatment of Tietze syndrome: a pragmatic randomized controlled trial
Study acronymOCTA
Study hypothesisOral corticosteroids may provide an additional benefit for patients with Tietze syndrome
Ethics approval(s)Approved 15/02/2020, Ain Shams University hospital ethical committee (Abbasia square, Cairo C237765, Egypt; no telephone number provided; Ethicalcommitee@ainshams.edu.eg), ref: 08/ASU01/47
ConditionTeitze syndrome: costochondritis of the chest wall with joint swelling
InterventionThe intervention group will have oral corticosteroid therapy for a short period in addition to all conventional methods of treatment.
The control group will have only the conventional treatment

Total duration of treatment = 3 weeks

Follow up period for the steroid arm 1-12 months, median 5.5 months

Follow up period for the NSAID arm 1-12 months, median 7 months

Median follow up period 6.5 months

Randomisation process by sealed envelope
Intervention typeDrug
Pharmaceutical study type(s)
PhasePhase III
Drug / device / biological / vaccine name(s)oral prednisolone
Primary outcome measure1. Pain measured using the NRS at 1, 2, 3 weeks and follow up period
2. Quality of life measured using the EURO 5Q-5D-5L score at 3 weeks
Secondary outcome measuresSize of joint swelling measured by patient interview at 3 weeks and 6 months after treatment.
Overall study start date15/02/2020
Overall study end date01/04/2022

Eligibility

Participant type(s)Patient
Age groupMixed
SexBoth
Target number of participants40
Total final enrolment40
Participant inclusion criteriaPatients aged 12 to 60 years old presenting with anterior or posterior chest wall swelling and/or palpable tenderness upon examination without any significant past medical history, or with history of recurrent chest infection or multiple minor chest trauma. Ultrasound of the sternocostal swellings was required to exclude other pathologies but no specific ultrasound finding was required to confirm the clinical diagnosis. Two senior thoracic surgeons were required to establish the diagnosis.
Participant exclusion criteria1. Patients diagnosed with myositis, coronary syndrome, chest wall tumors or mediastinal syndrome as diagnosed by clinical examination, CT chest, MRI chest or chest ultrasound.
2. Traumatic muscle pain, arthritis of sternoclavicular/sternomanubrial joints and fibromyalgia of costochondral junction.
3. Refused to be enrolled in the study or did not complete the full assessment at all time intervals.
Recruitment start date01/08/2020
Recruitment end date01/03/2022

Locations

Countries of recruitment

  • Egypt

Study participating centre

Thoracic surgery department, Ain Shams University
Abbasia square
Cairo
C234
Egypt

Sponsor information

Ain Shams University
Not defined

15 9th area buildings
Cairo
C237776
Egypt

Phone +20 1227373270
Email projectscenter@ainshams.edu.eg
Website http://www.asu.edu.eg/
ROR logo "ROR" https://ror.org/00cb9w016

Funders

Funder type

Other

Investigator initiated and funded

No information available

Results and Publications

Intention to publish date01/05/2022
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
Publication and dissemination planPlanned publication in a high-impact peer-reviewed journal
IPD sharing planData is available upon request from hanyhassan77@hotmail.com

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article 28/11/2022 29/11/2022 Yes No

Editorial Notes

29/11/2022: Publication reference added.
03/05/2022: Internal review.
28/04/2022: Trial's existence confirmed by Ain Shams University