Prednisolone Increases Thromboembolic Risk by Inducing Procoagulant State in Healthy Volunteers

HealthDay News – For healthy subjects, 10 days of prednisolone therapy induces a procoagulant state, according to a study published online in the Journal of Thrombosis and Haemostasis.

Christof J. Majoor, MD, from the Academic Medical Center in Amsterdam, and colleagues examined whether a 10-day prednisolone burst therapy activates hemostasis. Healthy individuals received either 0.5 mg/kg/day oral prednisolone (15 subjects) or placebo (16 subjects). Venous blood was collected at baseline, day 1, and day 10.

The researchers noted that the placebo group had higher peak thrombin and velocity index at baseline. Peak thrombin (15.8 versus −0.1), velocity index (41.2 versus −2.3), plasminogen-activator inhibitor type-1 (18.0 versus 0.5), and von Willebrand factor (4.0 versus 0.0) were increased in the oral prednisolone versus the placebo group after 10 days of treatment. There were no changes seen for thrombin-antithrombin complexes, endogenous thrombin potential, plasmin-alpha2-antiplasmin complexes, or D-dimer.

“Oral prednisolone induces a procoagulant state in healthy subjects, suggesting that corticosteroid treatment may increase thromboembolic risk in patients with inflammatory diseases,” the authors write.

Summary and Clinical Applicability

Prednisolone appears to have a procoagulant effect when taken by healthy subjects. This procoagulant state needs to be further investigated in the context of specific disease states. Prednisolone is used often in combination with disease-modifying antirheumatic drugs (DMARDs), and individual patient risk stratification in the context of comorbid disease should be considered when formulating a treatment plan. 


Majoor C, Sneeboer MM, de Kievit A, et al. The influence on corticosteroids on haemostasis in healthy subjects. J Thromb Haemost. 2016 Jan 21. doi: 10.1111/jth.13265. [Epub ahead of print]