Early prednisone therapy in Henoch-Schönlein purpura: a randomized, double-blind, placebo-controlled trial.

Abstract

OBJECTIVE:

To evaluate the efficacy of early prednisone therapy in preventing renal and treating extrarenal and renal symptoms in Henoch-Schönlein purpura (HSP) in a placebo-controlled trial.

STUDY DESIGN:

A total of 171 patients (84 treated with prednisone and 87 receiving placebo) were included and followed up for 6 months. The endpoints were renal involvement at 1, 3, and 6 months and healing of extrarenal symptoms. The analyses were performed on an intent-to-treat basis.

RESULTS:

Prednisone (1 mg/kg/day for 2 weeks, with weaning over the subsequent 2 weeks) was effective in reducing the intensity of abdominal pain (pain score, 2.5 vs 4.8; P = .029) and joint pain (4.6 vs 7.3; P = .030). Prednisone did not prevent the development of renal symptoms but was effective in treating them; renal symptoms resolved in 61% of the prednisone patients after treatment, compared with 34% of the placebo patients (difference = 27%; 95% confidence interval = 3% to 47%; P = .024).

CONCLUSIONS:

The general use of prednisone in HSP is not supported, but patients with disturbing symptoms may benefit from early treatment, because prednisone reduces extrarenal symptoms and is effective in altering (but not preventing) the course of renal involvement.

• Authors: Jaana Ronkainen, Olli Koskimies, Marja Ala-Houhala, Marjatta Antikainen, Jussi Merenmies, Jukka Rajantie, Timo Ormälä, Juha Turtinen, Matti Nuutinen
• Journal: The Journal of pediatrics (J Pediatr) Vol. 149 Issue 2 Pg. 241-7 (Aug 2006) ISSN: 0022-3476 [Print] United States
• PMID: 16887443 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Anti-Inflammatory Agents
• Prednisone

Topics

• Abdominal Pain (diagnosis, epidemiology)
• Adolescent
• Anti-Inflammatory Agents (adverse effects, therapeutic use)
• Arthralgia (diagnosis, epidemiology)
• Child
• Double-Blind Method
• Drug Administration Schedule
• Female
• Humans
• IgA Vasculitis (drug therapy, epidemiology)
• Kidney Diseases (diagnosis, epidemiology)
• Male
• Prednisone (adverse effects, therapeutic use)
• Prevalence
• Prospective Studies
• Risk Factors
• Severity of Illness Index
• Treatment Outcome