A comparison of daily and alternate-day prednisone therapy in the treatment of Duchenne muscular dystrophy.

• Abstract: We previously reported the results of a randomized, double-blind 6-month trial of prednisone therapy in which 102 boys aged 5 to 15 years with Duchenne muscular dystrophy received daily doses of 1.5 and 0.75 mg/kg per day and were compared with those receiving placebo. The strength and function in both prednisone-treated groups improved equally and were significantly better than in the placebo group. To compare alternate-day and daily dosing of prednisone with respect to benefits and adverse side effects, the placebo group was started on alternate-day prednisone therapy, and the treatment group regimens were changed to equivalent doses of alternate-day prednisone without breaking the double-blind nature. At the end of 6 months, the group that was changed from daily to alternate-day therapy had declined in strength back to levels observed 12 months previously, at the start of daily therapy. The group in which alternate-day therapy was started showed a significant improvement in strength at 3 months, similar in magnitude to the response of boys treated with daily therapy. However, their strength declined significantly in the subsequent 3 months compared with boys who received daily therapy. The frequency of side effects was not significantly different for alternate-day therapy compared with daily therapy. We conclude that alternate-day prednisone therapy effectively increases strength but does not sustain the improvement to the same extent as daily therapy or mitigate side effects.
• Authors: G M Fenichel, J R Mendell, R T Moxley 3rd, R C Griggs, M H Brooke, J P Miller, A Pestronk, J Robison, W King, L Signore (Affiliation: Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37212.)
• Journal: Archives of neurology (Arch Neurol) Vol. 48 Issue 6 Pg. 575-9 (Jun 1991) ISSN: 0003-9942 [Print] UNITED STATES
• PMID: 2039377 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Prednisone

Topics

• Adolescent
• Body Weight
• Child
• Child, Preschool
• Double-Blind Method
• Drug Administration Schedule
• Humans
• Male
• Muscular Dystrophies (drug therapy)
• Prednisone (administration & dosage, adverse effects)