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.