Observational studyPloS one2026
The paradoxical effect of oral prednisone in granulomatous lobular mastitis: An observational cohort study.
Observational study in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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5 authors.
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Abstract
backgroundDespite being a cornerstone therapy for granulomatous lobular mastitis (GLM), the use of oral prednisone lacks a standardized protocol due to undefined optimal parameters and insufficient large-scale evidence regarding its impact on disease recurrence.
objectivesThe retrospective cohort study comprehensively assessed the efficacy of oral prednisone for GLM by utilizing a large-scale cohort. It aimed to identify the optimal therapeutic protocol, with the ultimate aim of establishing a robust evidence base to inform standardized clinical guidelines.
methodsA cohort of 614 patients diagnosed with GLM was included in this study from January 2017 to December 2024. A three-dimensional evaluation of treatment timing (symptom-to-treatment interval), duration, and initial dosage (both absolute and weight-adjusted) was performed to identify prognostic factors and optimal cutoffs.
resultsOral prednisone was identified as an independent risk factor for recurrence (HR = 2.534, 95% CI: 1.615-3.975, P < 0.001). Survival curve analysis revealed that the 1-year recurrence rate was significantly higher in the oral prednisone group than in the non-prednisone group (29.4% vs. 14.6%, P = 0.001). Subgroup analysis showed that the long-interval, low-dose group (symptom-to-treatment interval > 6 weeks, dosage ≤ 0.4 mg/kg/day) yielded the most favorable results. The one-year recurrence rate of this group (6.2%) was significantly lower than other groups (all P < 0.05) and comparable to the non-prednisone group (14.6%, P = 0.233). Conversely, the short-interval group (symptom-to-treatment interval: 0-6 weeks) demonstrated the highest one-year relapse rate (33.5%), significantly exceeding that of the non-prednisone group (P < 0.001).
conclusionsWhile oral prednisone therapy may be associated with an increased relapse risk in GLM, an optimized protocol-initiating treatment after a 6-week symptom interval at a dose of ≤ 0.4 mg/kg/day-was identified to mitigate this risk. These findings highlight the paramount importance of treatment timing and dosage, offering a data-driven strategy to refine current therapeutic practices. Prospective studies are warranted to validate this proposed regimen.
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