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PubMed2002

[Treatment of hyperthyroid atrial fibrillation associated with Graves disease by prednisone].

OBJECTIVE: To investigate the clinical effect of prednisone on hyper thyroid atrial fibrillation associated with Graves disease (HAFGD). METHODS: Twenty-four patients with hyperthyroid atrial fibrillation associated with Graves disease were divided into two groups: traditional antithyroid group (10 cases, with 2 males and 8 females, treated by methimazole 15 approximately 30 mg/d and propranolol 15 approximately 30 mg/d) and prednisone group (14 cases with 3 males and 11 females, treated by methimazole 15 approximately 30 mg/d, propranolol 15 approximately 30 mg/d, and prednisone 30 mg/d). The effects of these two remedies on reversion from atrial fibrillation to sinus rhythm were compared. RESULTS: The cardiac rhythm reverted to sinus rhythm in 12 out of the 14 cases in prednisone group with a reversion rate of 86% and the mean reversion time of 3.8 months (range 3.8 +/- 2.6 months), and in 4 out of the 10 cases in traditional antithyroid remedy group with the mean reversion rate of 40% and mean reversion time of 2.8 months (range 2.8 +/- 1.0 months). The reversion rate was significantly higher in prednisone group than in the traditional remedy group (P < 0.05). CONCLUSION: Treatment of prednisone is more beneficial to reversion of atrial fibrillation into sinus rhythm among patients with HARGD.

Adult↗
PubMedDate not supplied

Glucocorticoid receptor up-regulation in early rheumatoid arthritis treated with low dose prednisone or placebo.

OBJECTIVE: Low or medium dose prednisone in early rheumatoid arthritis (RA), albeit with significant variation in clinical efficacy, reduces the progression of joint damage. The glucocorticoid receptor (GR) number in peripheral mononuclear cells (PBMC) might be helpful to predict which patients will respond to low or medium dose prednisone and therefore do not or will not need higher doses. With this in mind we determined in a double blind, placebo controlled study at baseline and yearly the GR number in PBMC. METHODS: Eighty-one early RA patients (disease duration less than one year) were included. All patients fulfilled the ACR criteria and were disease modifying antirheumatic drugs (DMARD) and glucocorticoid-naive. They were randomly assigned to treatment with 10 mg prednisone daily or placebo. From all patients disease activity (CRP, number of tender and swollen joints), the radiological joint score, bone mineral density, and the GR number in PBMC were measured annually. RESULTS: In females the GR number was up-regulated over time in both the prednisone and the placebo group. The same trend was observed in males. No correlations were found between the GR number in the prednisone users at the start of their treatment and changes in radiological scores or bone density after 2 years of treatment. No correlations were found between the GR number at the start and the clinical characteristics after a follow-up of 2 years. CONCLUSION: The GR number in the PBMC of early RA patients did not predict which patients would be prednisone responders based on clinical or radiological parameters. However, the up-regulation of the GR number in PBMC in early RA patients towards the GR number of healthy subjects during the first two years of their disease course seems to reflect a recovery or compensatory mechanism as a response to an ongoing inflammatory process. This recovery may be not enough to efficiently control the inflammatory situation.

Adult↗
PubMed2005

[Outcome of treatment 46 patients with Bell's palsy with aciclovir and prednisone].

PURPOSE: To evaluate the outcome of treatment with an antiviral drug in combination with corticosteroids in patients with Bell's palsy. METHODS: 46 patients with Bell's palsy were randomly divided into two groups, aciclovir and prednisone group (A+P group, n=23) and prednisone group (P group, n=23). The patients in A+P group were treated with 0.4g of aciclovir tablets 3 times per day for 5 days and 50 mg of prednisone daily for 5 days, and the patients in P group were treated with 50 mg of prednisone daily for 5 days, and then the dosage of prednisone was reduced by 20 mg per two days for the next 10 days. Facial nerve function index (FNFI) was used as a evaluating method of the outcome. RESULTS: 12 patients (52.1%) in the A+P group recovered completely (FNFI=1), as compared with 5 patients (21.7%) in the P group (P<0.05) after treatment three weeks, and 21 patients (91.3%) in the A+P group comparing with 18 patients (78.3%) in the P group (P>0.05) after treatment four weeks. CONCLUSIONS: The study showed a significantly better outcome in the patients with Bell's palsy treated with aciclovir and predisone as compared with the patient given prednisone treatment without serious complications.

Acyclovir↗
PubMedDate not supplied

[Treatment outcome using prednisone in corticosteroid-responsive primary nephrotic syndrome in children].

In children, the nephrotic syndrome is usually corticoid-responsive; approximately 70% of patients experience relapses, frequently triggered by infections. Our paper presents the results obtained using a 4 month prednisone regimen. This retrospective study included 83 children afflicted with nephrotic syndrome over a 10 year span. We analyzed: age at diagnosis, boys/girls ratio, response to corticoid treatment - after one month of prednisone and at the completion of the treatment course, number of relapses and their frequency, complications of prednisone treatment. The median age at diagnosis was 4.8 years, males predominating M:F = 1.5:1. Complete response after 4 weeks of prednisone therapy was noted in 98.79% of cases. We had 116 episodes of relapses during the first year of follow-up, occurring in 67.4% of children (27.9% were frequent relapsers, 11.62% subsequently became corticoid-dependent). Late relapses, after the first year, occurred in 32.55% of cases. We noted mostly mild adverse effects of the prednisone treatment: occurrence of infections during therapy (16.27%), cushingoid facies (37.2%), hirsutism (4.6%), high blood pressure (4.65%), stretch marks (2.32%). In conclusion, the 4 month prednisone treatment regimen is efficient in inducing and maintaining a remission. The incidence of relapses is 32.55%, comparable to the figure cited in larger studies. Serious adverse effects are significantly lower with this regimen compared to other corticoid treatment schemes. Key wo

Adolescent↗
PubMed2006

Prednisone monotherapy in asymptomatic hormone refractory prostate cancer.

BACKGROUND: Patients with advanced prostate cancer eventually cease to respond to hormonal therapy and thus progress to hormone refractory prostate cancer (HRPC). Prednisone has been used in this setting; however, limited data is available for this monotherapy in the asymptomatic HRPC population. OBJECTIVE: To evaluate the PSA response rate to prednisone in asymptomatic patients with hormone refractory prostate cancer (HRPC). Secondary objectives were to determine toxicity, predictors of response, and to determine overall survival of this population. METHODS: Patients with asymptomatic HRPC that were treated with low dose prednisone from April 1998 to 2003 were identified from the British Columbia Cancer Agency patient and pharmacy registries. Inclusion criteria were an ECOG Performance Status of 2 at the time of prednisone initiation, prior medical or surgical orchidectomy, a rising PSA, and no symptoms from prostate cancer. Demographic data, lab values, serial PSAs, and survival data were collected. Univariate analyses were performed to evaluate potential predictors of response. RESULTS: Forty-nine patients met the inclusion criteria. There was a 22.4% response rate to prednisone as defined by a 50% PSA decline. An additional 16.3% of patients had a PSA decline of < 50%. Ninety percent of patients had no documented side effects. PSA responders were more likely to have bony metastases (9/11 versus 17/38, p = 0.03) and lived longer (24.7 versus 15.4 months median survival p = 0.02). The median duration of response in the PSA responders was 4.3 months (0.89-30). Of all PSA responders, 27% had a time to progression greater than 1 year and 45% did not require chemotherapy for the duration of the study. CONCLUSION: Prednisone monotherapy is well tolerated and is associated with a clinically relevant response rate in patients with asymptomatic HRPC. Prolonged time to progression and thus avoidance of more toxic chemotherapy is possible in some patients.

Adenocarcinoma↗
PubMed1991

Low dose prednisone treatment does not reduce the severity of osteoarthritis in dogs after anterior cruciate ligament transection.

It was reported recently that oral administration of prednisone, 0.3 mg/kg/day, decreased osteophyte size and cartilage ulceration in dogs with osteoarthritis (OA) produced by "stab" transection of the anterior cruciate ligament. Since this dose would be equivalent to 17 mg/day for a 70-kg human, our study was performed to determine whether a lower, clinically more realistic, dose of prednisone also had ameliorating effects on OA in the canine model. Following arthrotomy and transection of the anterior cruciate ligament 10 adult mongrel dogs were each given prednisone, 0.1 mg/kg/day, begun either 0, 2, or 4 weeks after arthrotomy and continued until sacrifice 12 weeks after surgery; 7 others underwent the identical surgical procedure but received no prednisone and served as OA controls. No differences were noted between dogs treated with prednisone and the controls with respect to size or extent of osteophytes, severity of synovial inflammation, morphologic changes of OA in articular cartilage, or in vitro synthesis of glycosaminoglycans. Increases in cartilage thickness in the OA knee were similar in the 2 groups, as were increases in H2O content and uronic acid concentration. Regardless of the interval between arthrotomy and start of treatment, the low dose of prednisone used here did not reduce the severity of OA in this model.

Animals↗
PubMed1991

Prednisone plus azathioprine treatment in patients with rheumatoid arthritis complicated by vasculitis.

The therapeutic effect of prednisone combined with azathioprine was studied in 28 patients with rheumatoid vasculitis. Nine patients with severe systemic vasculitis were treated initially with 60 mg of prednisone and 2 mg/kg of body weight of azathioprine daily. Clinical signs of vasculitis decreased in all patients. Nineteen patients with only cutaneous vasculitis entered a randomized controlled study comparing prednisone plus azathioprine treatment vs continuation of various conventional antirheumatic drugs. Although measures of both vasculitis and arthritis activity improved to a greater degree in the patients treated with prednisone plus azathioprine in the first 3 months of therapy, no significant differences between the results of the two treatments were observed at the end of the follow-up period. Prednisone plus azathioprine treatment was associated with a low incidence of relapse of vasculitis, few serious complications, and a relatively low mortality. We conclude that the combination of prednisone and azathioprine is effective in the treatment of severe systemic rheumatoid vasculitis; rheumatoid vasculitis with only cutaneous manifestations has a relatively good prognosis, and there is probably no indication for therapy specifically directed at the vasculitic process.

Aged↗
PubMed1991

Effect of high-dose dexamethasone in prednisone-resistant autoimmune thrombocytopenic purpura (ITP).

This study investigated whether high-dose dexamethasone pulse therapy could bring about a remission in adult chronic idiopathic thrombocytopenic purpura (ITP) patients who had not achieved a remission on the usual prednisone therapy. Newly diagnosed patients with ITP received the usual prednisone therapy, 1 mg/kg/day, for 3 weeks, after which period the dosage was tapered off. If after 6 weeks of treatment the platelets were less than 50 x 10(9)/l the prednisone therapy was considered a failure and 200 mg dexamethasone i.v. was given on 3 consecutive days. Six of the twenty-five patients with newly diagnosed ITP treated according to this protocol achieved a sufficient response with prednisone therapy. Nineteen patients were resistant to or relapsed during prednisone therapy and were treated with high-dose dexamethasone. Four of these nineteen patients showed a sufficient response. Three are still in remission. As no serious adverse effects were observed, high-dose dexamethasone therapy can be considered before splenectomy in prednisone- resistant ITP patients.

Adolescent↗
PubMedDate not supplied

Pharmacokinetics of prednisone and prednisolone at steady state in the rabbit.

A range (approximately 0.2-2.0 micrograms/min/kg) of constant rate iv infusions of prednisolone (as the phosphate ester) was administered to five rabbits either singly or as two consecutive infusions, and then again at about the same rates of infusion as part of multiple infusion studies. Prednisone (as the succinate) was also infused at three different infusion rates (range, 1.5-15 micrograms/min/kg) to four of the five rabbits. Plasma concentrations of prednisolone and prednisone at steady state were measured by HPLC. The binding of prednisone and prednisolone in plasma was measured by equilibrium dialysis. The multiple infusion studies demonstrated that the nonlinearity in plasma clearance of prednisolone could not be attributed to any time-dependent effect. The average plasma clearance of prednisolone increased by 250% when its rate of infusion was increased 10-fold. The ranges of clearance values at low and high rates of infusion were 2.51-4.08 and 6.08-10.98 ml/min/kg, respectively. The binding of prednisolone in plasma was found to be concentration dependent. At the lower rates of infusions, the clearance of unbound prednisolone appeared to increase on increasing its rate of infusion but remained relatively constant thereafter (greater than 1.0 microgram/min/kg). The ranges of unbound plasma prednisolone clearance at low and high rates of infusions were 30.3-67.7 and 50.6-110.2 ml/min/kg, respectively. The percentage of unbound prednisone increased on increasing the total plasma prednisone concentration (ranges at low and high concentrations of prednisone were 15.5-33.7 and 32.3-47.6%).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1988

Short versus standard prednisone therapy for initial treatment of idiopathic nephrotic syndrome in children. Arbeitsgemeinschaft für Pädiatrische Nephrologie.

Two regimens of steroid treatment for the initial attack of idiopathic nephrotic syndrome in children were compared in a controlled multicentre study. Short-course prednisone therapy consisted of 60 mg/m2 per 24 h until proteinuria had disappeared for 3 days, followed by 40 mg/m2 per 48 h until complete remission had occurred. The standard prednisone therapy was 60 mg/m2 per 24 h for 4 weeks, followed by 40 mg/m2 per 48 h for 4 weeks. 61 children with a first attack of idiopathic nephrotic syndrome were allocated at random to these groups. Urinary remission in the short-course group was achieved after 14 days of daily prednisone, and complete remission after an additional 16 days of alternate day prednisone. The cumulative rate of patients with sustained remissions after two years was significantly lower after the short course than after standard treatment (19% versus 41%, p = 0.001). The mean duration of remission in patients with a relapse was half as long after the short course (79 versus 169 days, p = 0.004). Complete initial remission of steroid responsive nephrotic syndrome can be obtained with half the standard prednisone dose, but the short course is followed by a higher rate of relapses, that require repeated prednisone administrations. In the long term, the standard regimen is preferable.

Adolescent↗
PubMed1988

[Comparative serum pharmacokinetics of prednisone and prednisolone methylsulfobenzoate after oral administration].

Pharmacokinetic values of prednisone and prednisolone were measured in the serum of 6 healthy volunteers after oral administration of either prednisolone methylsulfobenzoate 30 mg or prednisone 30 mg. Peak serum concentrations of prednisolone obtained after dosing with prednisone occurred earlier and were higher (473 +/- 106 ng/ml) than those obtained after dosing with prednisolone methylsulfobenzoate (232 +/- 70 ng/ml; P less than 0.01). Similarly, areas under the 0-8 h concentration curves were significantly greater after dosing with prednisone than after dosing with prednisolone methylsulfobenzoate (prednisolone: P less than 0.001; prednisone: P less than 0.02). The differences may be due to prednisolone methylsulfobenzoate not being absorbed as well as prednisone. These kinetic data may warrant a reappraisal of the therapeutic equivalence of the two drugs taken for granted in France.

Administration, Oral↗
PubMed1988

[Removal of prednisone and prednisolone during plasma exchange].

Prednisone and prednisolone extraction was determined during seven sessions of plasma exchange in four patients. Each patient received 0.5 mg/kg of prednisone administered orally 2 hours before plasma exchange. Concentrations of prednisone and prednisolone were determined in blood before, every half hour during and at the end of plasma exchange. Both drugs were also determined in removed plasma, mean volume of removed plasma being 0.96 plasmatic mass. The amount of combined prednisone and prednisolone removed by plasma exchange was 1.70% of the administered prednisone dose. This quantity appears minimal and supplemental dosing of prednisone or modification of administration time would seem to be unnecessary.

Chromatography, High Pressure Liquid↗
PubMed1979

Adrenocortical suppression in dogs on daily and alternate-day prednisone administration.

Three groups of eight normal dogs each were orally given prednisone at doses of 0.22 mg/kg of body weight/day, 0.55 mg/kg/day, or 1.1 mg/kg on alternate mornings. Four dogs served as nontreated controls. Samples were obtained from members of each group to determine baseline serum cortisol and ACTH-stimulated cortisol values and histologic features in the lateral thoracic skin before prednisone administration, and after 1, 2, 3, and 4 weeks of administration. Some animals from each group were necropsied after 1, 2, 3, and 4 weeks of prednisone administration. Each course of prednisone administration resulted in adrenocortical atrophy and hypofunction, but adrenocortical suppression was less severe and slower in onset in the group given prednisone on alternate days. Extra-adrenal effects observed were atrophy of the skin and focal, fatty change of the liver. These changes were most evident in dogs given daily pharmacologic doses of prednisone (0.55 mg/kg/day). Fewer extra-adrenal effects were observed in dogs given alternate-day therapy. There were no extra-adrenal lesions in the dogs given equivalent glucocorticoid replacement doses (0.22 mg/kg/day).

Administration, Oral↗
PubMed1975

Inhaled corticosteroids compared with oral prednisone in patients starting long-term corticosteroid therapy for asthma. A controlled trial by the British Thoracic and Tuberculosis Association.

Inhaled beclomethasone dipropionate and inhaled betamethasone valerate have been compared with oral prednisone in the treatment of 75 patients with asthma who were starting long-term corticosteroids for the first time. Both of the inhaled corticosteroids controlled asthma as well as did oral prednisone in those who had responded to therapy in the initial period of the trial. A daily dose of 400 mug of inhaled drug was approximately equivalent to 7-5 mg daily of prednisone. Prednisone suppressed the adrenal response to tetracosactrin, whereas the mean responses in the groups receiving inhaled corticosteroids did not change significantly from pre-trial values. The 30% incidence of other systemic unwanted effects of prednisone contrasted sharply with the low incidence (5%) of symptomatic oropharyngeal candidiasis in the patients receiving inhaled corticosteroids. In a sample of 19 patients no change in exfoliative cytology was detected over the period of the trial nor was there any evidence of fungal colonisation of the bronchial tree. There was no difference between the three treatment groups in the number of antibiotic courses prescribed. The persistent production of sputum made no difference to the response to inhaled corticosteroids. Patients not on sodium cromoglycate did as well in the trial as those receiving sodium cromoglycate. Both inhaled beclomethasone dipropionate and inhaled betamethasone valerate have advantages over oral prednisone in the maintenance treatment of patients with asthma, but in the management of exacerbations systemic corticosteroids will usually be needed as a supplement to inhaled therapy.

Administration, Intranasal↗
PubMedDate not supplied

Adrenal response to serial cosyntropin stimulation after repeated high-dose prednisone administration in patients with lymphoma.

To determine if repeated courses of high-dose prednisone given to patients with lymphoma as part of multiple-drug chemotherapy programs would lead to progressive adrenal suppression, serial cosyntropin stimulation tests were performed. Four patients with diffuse histiocytic lymphoma (group 1) received prednisone for 5 days every 3 weeks for five courses, and five patients with Hodgkin's disease (group 2) received prednisone for 14 days every 4 weeks for six courses. Testing was done on Day 1 of each treatment course prior to the administration of therapy and after the final course of chemotherapy. In group 1 patients, there was no evidence of adrenal suppression after any of the courses of prednisone. The plasma cortisol increments after cosyntropin injection were also normal. In the group 2 patients, significant depression of basal plasma cortisol concentrations was observed after the first and fifth courses of prednisone, compared to the pretreatment values. The depression reflected the previous course of prednisone administration only and was not progressive with subsequent courses. The plasma cortisol increments after cosyntropin injection were normal despite depressed basal plasma cortisol levels.

Adrenal Cortex Function Tests↗
PubMed1983

Effect of prednisone on thyroid gland morphology and plasma thyroxine and triiodothyronine concentrations in the dog.

The effects of multiple IM injections of prednisone (2.2 mg/kg) on thyroid morphology and on plasma thyroxine (T4) and triiodothyronine (T3) concentrations in dogs were determined, and the effects of a single prednisone injection on the same circulating iodothyronine concentrations were assessed. Plasma T4 and T3 concentrations decreased significantly after 3 injections of prednisone were made. However, with a single prednisone injection, there was no significant difference in plasma T4 values between control and treated animals. Starting at 8 hours after a single prednisone injection and continuing through day 2, plasma T3 values were significantly lowered. Prednisone treatment also resulted in significantly more thyroid cytoplasmic colloid droplets per follicular cell (3.19 vs 0.57 in treated and control dogs). Lysosomal hydrolysis of colloid appeared to be inhibited by glucocorticoids in dogs, resulting in an alteration of normal thyroid gland functioning.

Animals↗
PubMed1995

Independent parental administration of prednisone in acute asthma: a double-blind, placebo-controlled, crossover study.

OBJECTIVE: To determine the effectiveness of a single dose of prednisone administered by a parent to a child early in an asthma attack. DESIGN: A randomized, double-blind, placebo-controlled, crossover study with children enrolled for 12 months (6 months prednisone, 6 months placebo). SETTING: A primary-care clinic and emergency department of an inner-city teaching hospital from March 1992 through May 1993. CHILDREN: Children 2 to 14 years of age enrolled in this clinic who had made two or more outpatient (emergency department or primary-care clinic) visits for acute asthma in the preceding year. SELECTION: There were 204 eligible children, of whom 86 were contacted and enrolled; of these, 78 (91%) completed the study. INTERVENTION: Capsules containing prednisone (2 mg/kg up to 60 mg) or placebo. Parents were instructed to give their child one capsule for an asthma attack that had not improved after a dose of the child's regular acute asthma medicine. MEASUREMENTS: Parents were interviewed every 3 months. Computerized patient records and chart reviews were used to verify parent reports. Outcome measures were the numbers of outpatient visits and hospitalizations for treatment of acute asthma. RESULTS: Neither the total number of attacks nor the number for which medicine was used differed significantly by arm of study. There was a larger number of attacks resulting in outpatient visits when children were in the group that received prednisone (1.1 +/- 0.59 versus 0.59 +/- 0.86). This trend was less pronounced but persisted when limited to attacks for which the medicine was given (0.58 +/- 0.99 versus 0.35 +/- 0.55). Neither the number of attacks resulting in admission nor the number of hospital days differed significantly by arm of study. CONCLUSIONS: A single dose of prednisone available for use at home early in an asthma attack was associated with an increase in outpatient visits made for acute asthma. When prednisone was given for an attack, there was no reduction in outpatient visits. This intervention can not be recommended for children with asthma. These results should be confirmed in other pediatric populations.

Acute Disease↗
PubMed1993

Controlled trial of oral prednisone in the emergency department treatment of children with acute asthma.

BACKGROUND: Recent studies have shown that the use of parenteral corticosteroids in the emergency department decreases the hospitalization rate for patients with acute asthma. We studied the efficacy of oral corticosteroids in the emergency department treatment of moderately ill children with acute asthma. METHODS: Emergency department patients aged 1 through 17 years whose chief complaint was acute asthma were assigned a pulmonary index, based on clinical evaluation. Those with a moderate exacerbation (pulmonary index = 9 through 13) received either 2 mg/kg of oral prednisone or placebo in a randomized, double-blind fashion. Patients in each group were then treated with an identical regimen of frequent aerosolized albuterol, for up to a maximum of 4 hours. RESULTS: Seventy-five patients were assessed. Overall, 11 (31%) of 36 in the prednisone group required hospitalization compared with 19 (49%) of 39 in the placebo group (P = .10). Among the sickest patients (initial pulmonary index > 10), 7 (32%) of 22 prednisone-treated patients required hospitalization compared with 13 (72%) of 18 placebo-treated patients (P < .05). Among patients who had a suboptimal response to initial beta 2-agonist therapy and who therefore would have been hospitalized had treatment been restricted to 2 hours, 9 (45%) of 20 in the prednisone group ultimately required hospitalization when duration of care was extended 2 additional hours compared with 15 (83%) of 18 in the placebo group (P < .05). In addition, prednisone-treated patients had a significantly greater improvement in median pulmonary index (5.0 vs 3.0, P < .001). CONCLUSIONS: These data demonstrate that oral prednisone, within 4 hours of its administration, reduced the need for hospitalization among a subset of children treated in the emergency department for acute asthma.

Acute Disease↗