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Effects of long-term maintenance therapy with a new glucocorticoid, deflazacort, on mineral metabolism and statural growth.

Abstract
Deflazacort was substituted for Prednisone (based on the equivalence 1 mg Prednisone equals 1.2 mg Deflazacort), during maintenance glucocorticoid therapy in 9 children, 5 with renal diseases and 4 with connective tissue or immunoproliferative disorders. Six patients received 0.26-0.35 mg/kg body weight (B.W.)/day and 3 0.48-1.2 mg/kg B.W. on alternate days, for 10-16 months. Except for a child with chronic juvenile arthritis, who was also unresponsive to Prednisone, the therapeutic effects of Deflazacort were excellent. Steroid side effects present in 8 patients decreased or disappeared. Plasma Ca, P, Mg, creatinine, alkaline phosphatase, iPTH(1-34), urinary excretion of Ca, cAMP, and TRP remained normal. Plasma iPTH(1-84) remained normal in 5 children; in the other 4 patients it increased from normal to slightly elevated values. On Deflazacort, plasma calcidiol concentrations were within the normal range in 6/8 patients prescribed daily doses of vitamin D2 (1,600-2,400 IU) or calcidiol (20 micrograms). Plasma 1,25(OH)2D levels monitored in 5 children were also normal. The osteoporosis, evaluated on the tibial cortico-diaphyseal ratio and the trabecular aspect of bone radiograms, present in 5 patients, persisted in 1 and improved in the others. On Deflazacort, statural growth proceeded normally in all subjects, with a modest acceleration of growth velocity in 3 children. These results seem encouraging for extending clinical trials with Deflazacort to the active phase of pediatric diseases requiring glucocorticoid.
AuthorsS Balsan, D Stéru, A Bourdeau, R Grimberg, G Lenoir
JournalCalcified tissue international (Calcif Tissue Int) Vol. 40 Issue 6 Pg. 303-9 (Jun 1987) ISSN: 0171-967X [Print] GERMANY, WEST
PMID3111667 (Publication Type: Comparative Study, Journal Article)
Chemical References
  • Anti-Inflammatory Agents, Non-Steroidal
  • Minerals
  • Parathyroid Hormone
  • Pregnenediones
  • deflazacort
  • Calcifediol
  • Calcium
  • Prednisone
Topics
  • Adolescent
  • Anti-Inflammatory Agents, Non-Steroidal
  • Arthritis (drug therapy)
  • Body Height
  • Bone Diseases, Metabolic (chemically induced)
  • Bone and Bones (metabolism)
  • Calcifediol (blood)
  • Calcium (blood)
  • Child
  • Child, Preschool
  • Female
  • Growth Disorders (chemically induced)
  • Humans
  • Kidney Diseases (drug therapy)
  • Male
  • Minerals (metabolism)
  • Parathyroid Hormone (blood)
  • Prednisone (adverse effects, therapeutic use)
  • Pregnenediones (adverse effects, therapeutic use)

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