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Ophthalmology. Glaucoma 2022To evaluate the effect of postoperative topical prednisolone acetate and difluprednate on surgical outcomes of Ahmed glaucoma valve (AGV) implantation.
PURPOSE
To evaluate the effect of postoperative topical prednisolone acetate and difluprednate on surgical outcomes of Ahmed glaucoma valve (AGV) implantation.
DESIGN
Retrospective, comparative case series.
PARTICIPANTS
The study population consisted of 102 eyes of 90 patients, including 52 eyes that received 1% prednisolone acetate (Pred Forte [PF]; Allergan Inc) and 50 eyes that received 0.05% difluprednate (Durezol [DZ]; Novartis Inc).
METHODS
The medical records of consecutive patients who underwent AGV implantation at the University of California, San Francisco, were retrospectively reviewed. Patients in the PF group received 1% prednisolone acetate 6 to 8 times per day tapered over 5 to 6 months postoperatively, and patients in the DZ group received 0.05% difluprednate 4 times daily tapered over 4 months postoperatively.
MAIN OUTCOME MEASURES
Intraocular pressure (IOP), number of glaucoma medications, visual acuity (VA), postoperative complications, and the rate of treatment success.
RESULTS
At 1 year, the IOPs (mean ± standard deviation) were 12.4 ± 3.7 mmHg in the DZ group and 13.0 ± 4.0 mmHg in the PF group (P = 0.49). The numbers of glaucoma medications were 0.72 ± 0.71 in the DZ group and 1.09 ± 0.91 in the PF group (P = 0.04), with reductions from baseline of 2.5 ± 1.0 glaucoma medications in the DZ group and 1.8 ± 1.6 glaucoma medications in the PF group (P = 0.01). The logarithm of the minimum angle of resolution VAs (mean ± standard deviation) were 0.55 ± 0.80 in the DZ group and 0.59 ± 0.65 in the PF group after 1 year of follow-up (P = 0.81). The cumulative probabilities of success were 95.8% in the DZ group and 93.5% in the PF group at 1 year (P = 0.61). Postoperative complications occurred in 4 eyes (7.7%) in the DZ group and 6 eyes (12%) in the PF group (P = 0.52).
CONCLUSIONS
After 1 year, postoperative treatment with 0.05% difluprednate after AGV implantation resulted in a similar IOP, with the use of fewer glaucoma medications, compared with postoperative treatment with 1% prednisolone acetate. The rates of treatment success and surgical complications were comparable between the 2 groups during the first year of follow-up.
Topics: Fluprednisolone; Follow-Up Studies; Glaucoma; Glaucoma Drainage Implants; Humans; Postoperative Complications; Prednisolone; Retrospective Studies; Treatment Outcome
PubMed: 35304317
DOI: 10.1016/j.ogla.2022.03.003 -
Biomedical Papers of the Medical... Sep 2014Glucocorticoids, particularly prednisone/ prednisolone and dexamethasone, play a prominent role in the treatment of pediatric patients with acute lymphoblastic leukemia... (Comparative Study)
Comparative Study
Combination of prednisolone and low dosed dexamethasone exhibits greater in vitro antileukemic activity than equiactive dose of prednisolone and overcomes prednisolone drug resistance in acute childhood lymphoblastic leukemia.
INTRODUCTION
Glucocorticoids, particularly prednisone/ prednisolone and dexamethasone, play a prominent role in the treatment of pediatric patients with acute lymphoblastic leukemia due to their ability to induce apoptosis in susceptible cells. Current therapeutic protocols use prednisone for both the prophase and the induction phase of the therapy because the greater antileukemic activity of dexamethasone is compromised by its high frequency of serious adverse reactions.
AIM
To compare, for the first time, the in vitro antileukemic activity of prednisolone alone to that of a combination of prednisolone and dexamethasone using dexamethasone at a very low and presumably safe dosage (1/50 w/w).
METHODS
Lymphoblasts were isolated from bone marrow and/or blood samples from children with newly diagnosed acute lymphoblastic leukemia. The cytotoxic activity of prednisolone, dexamethasone and the prednisolone/dexamethasone combination against isolated leukemia cells was analyzed using the MTT cytotoxicity assay.
RESULTS
We observed differences in the in vitro antileukemic activity of prednisolone and dexamethasone in 21% of the tested patients. 3% of the children were prednisolone sensitive but dexamethasone resistant, while 18% were prednisolone resistant and dexamethasone sensitive. 32% were sensitive to both glucocorticoids and 18% were resistant to both. Cells from patients with good in vivo responses to prednisone monotherapy were more responsive to prednisolone in vitro than were cells from patients with poor prednisone responses (P<0.07). Importantly, we demonstrated that the use of even a minimal dose (1/50 w/w) of dexamethasone with prednisolone dramatically increases the in vitro anti-leukemic activity of prednisolone (P<0.0006).
CONCLUSION
The high inter-individual variability of acute lymphoblastic leukemia responses to glucocorticoids suggest that either patients should be selected for prednisone or dexamethasone treatment on the basis of predictive biomarkers or that prednisone should be used directly in combination with a very low and safe dose of dexamethasone to potentiate its antileukemic activity. The latter option is likely to be cheaper and more efficient, and therefore warrants further clinical investigation to assess its efficacy and safety in treating childhood acute lymphoblastic leukemia.
Topics: Child; Dexamethasone; Drug Resistance, Neoplasm; Drug Therapy, Combination; Glucocorticoids; Humans; In Vitro Techniques; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Prednisolone
PubMed: 23128824
DOI: 10.5507/bp.2012.059 -
The American Journal of Case Reports Nov 2021BACKGROUND Penile abscesses were traditionally regarded as an infectious disease; however, idiopathic cases in which prednisolone was effective have been reported. CASE...
BACKGROUND Penile abscesses were traditionally regarded as an infectious disease; however, idiopathic cases in which prednisolone was effective have been reported. CASE REPORT A 64-year-old man was admitted to the hospital with symptoms of penile induration and dysuria. He was diagnosed with a penile abscess, which was punctured and then relapsed. An incision and drainage were performed on the abscess, and the pus and tissue samples were cultured and examined histologically. There was no evidence of malignancy or bacterial infection, and he was diagnosed with an idiopathic penile abscess. As pus continuously drained from the incision, prednisolone 40 mg was initiated, which resulted in a decreased amount of pus and eventual wound closure. Over 15 months, prednisolone was gradually tapered to 5 mg, and the abscess continued to decrease in size. CONCLUSIONS Idiopathic penile abscesses are rare but often lead to penectomy. Prednisolone is a new treatment method for such patients. This is the third case of an idiopathic penile abscess that was successfully treated with prednisolone. The causative agent of the idiopathic penile abscess was suggested to be pyoderma gangrenosum; however, this case did not exhibit the typical characteristics of pyoderma gangrenosum. Therefore, further investigation was needed. A differential diagnosis of an infectious abscess is required before initiating steroid treatment. Open drainage is useful, but the size of the incision should be minimized for the purpose of preserving penile function. The prednisolone dose should be started at 20 to 40 mg and reduced gradually to avoid relapse.
Topics: Abscess; Diagnosis, Differential; Drainage; Humans; Male; Middle Aged; Prednisolone; Pyoderma Gangrenosum
PubMed: 34758004
DOI: 10.12659/AJCR.933618 -
Kidney International Feb 1985Prednisolone pharmacokinetics and protein binding have been compared in 16 cushingoid and 46 non-cushingoid long-term kidney transplant recipients. After oral... (Comparative Study)
Comparative Study
Prednisolone pharmacokinetics and protein binding have been compared in 16 cushingoid and 46 non-cushingoid long-term kidney transplant recipients. After oral administration of 10 mg prednisolone, the cushingoid patients had a significantly higher peak prednisolone serum concentration (P less than 0.03), a longer elimination half-time (P less than 0.03), and a larger area under the time-concentration curve of total (P less than 0.01) and free (P less than 0.03) prednisolone. The apparent total body clearance of total and free prednisolone was significantly lower in the cushingoid than in the non-cushingoid patients (P less than 0.02 and less than 0.05, respectively). There was no significant difference in time of peak concentration, apparent volume of distribution or serum protein binding of prednisolone. It is suggested that the development and persistency of some cushingoid features may be related to a decreased total body clearance of prednisolone, which, in turn, may be influenced by impaired renal function.
Topics: Adult; Creatinine; Cushing Syndrome; Female; Half-Life; Humans; Kidney Function Tests; Kidney Transplantation; Kinetics; Male; Middle Aged; Prednisolone; Protein Binding; Time Factors
PubMed: 3887001
DOI: 10.1038/ki.1985.31 -
BMJ Open Apr 2014To examine the long-term effects of early low-dose prednisolone use in patients with rheumatoid arthritis (RA) on cardiovascular (CV) morbidity and mortality. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To examine the long-term effects of early low-dose prednisolone use in patients with rheumatoid arthritis (RA) on cardiovascular (CV) morbidity and mortality.
DESIGN
Retrieval of data from a 2-year open randomised trial comparing prednisolone 7.5 mg/day in addition to disease-modifying antirheumatic drugs (DMARDs) with DMARD therapy alone. Participants were followed for 10 years since inclusion into the original prednisolone trial or until occurrence of the studied outcomes.
SETTING
Secondary level of care; six participating centres from southern Sweden; both urban and rural populations.
PARTICIPANTS
Overall, 223 patients with early RA were included. The participants had no history of CV events at baseline and incident cases were identified via the Swedish Hospital Discharge and Cause of Death Registries.
OUTCOMES
Composite CV events, that is, ischaemic coronary and cerebrovascular events, components of the composite CV outcome, and death. Relative HRs from Cox proportional-hazards regression models were calculated.
RESULTS
Within 2041 person-years, 17 incident composite CV events occurred in 112 patients (15%) randomised to prednisolone, and 15 events of 111 patients (14%) who were assigned not to receive prednisolone. There were nine deaths (8%) in each group. The age-adjusted relative hazards (HRs; 95% CI) for the first composite CV event, first coronary event and death in the prednisolone group versus the group not treated with prednisolone were 1.8 (0.9 to 3.6), 0.98 (0.4 to 2.6) and 1.6 (0.6 to 4.1), respectively. The risk for the first cerebrovascular event showed a 3.7-fold increased relative hazard (95% CI 1.2 to 11.4) among prednisolone treated patients.
CONCLUSIONS
In this inception cohort study of low-dose prednisolone use during the first 2 years of RA disease, the incidence of ischaemic coronary artery events was similar in the two treatment groups, whereas the long-term risk of ischaemic cerebrovascular events was higher in the prednisolone group. There was a trend towards reduced survival in the prednisolone group.
TRIAL REGISTRATION NUMBER
ISRCTN20612367.
Topics: Age Factors; Anti-Inflammatory Agents; Arthritis, Rheumatoid; Cardiovascular Diseases; Coronary Disease; Female; Follow-Up Studies; Humans; Male; Middle Aged; Prednisolone; Proportional Hazards Models; Risk Factors; Sweden
PubMed: 24710131
DOI: 10.1136/bmjopen-2013-004259 -
BMC Veterinary Research Sep 2014Prednisolone was one of the first glucocorticoids to be synthesised, but it is still widely applied to cattle. Illegal uses of prednisolone include its uses for masking...
BACKGROUND
Prednisolone was one of the first glucocorticoids to be synthesised, but it is still widely applied to cattle. Illegal uses of prednisolone include its uses for masking a number of diseases before animal sale and, at lower dosages for extended periods of time, for the improvement of feed efficiency and carcass characteristics. Since occasional presence of prednisolone has been detected at trace level in urine samples from untreated cattle, the Italian Ministry of Health introduced a provisional limit of 5 ng/mL to avoid false non-compliances. However, this limit proved ineffective in disclosing prednisolone misuse as a growth-promoter. In the present study, prednisolone acetate was administered to finishing bulls and cows according to a therapeutic protocol (2 × 0.4-0.5 mg/kg bw i.m. at 48 h interval) to further verify the practical impact of this cut-off limit and develop sound strategies to distinguish between exogenous administration and endogenous production. Urinary prednisolone, prednisone, 20β-dihydroprednisolone, 20α-dihydroprednisolone, 20β-dihydroprednisone, 6β-hydroxyprednisolone, cortisol, and cortisone were determined using a validated LC/MS-MS method.
RESULTS
The urinary excretion profile showed the simultaneous presence of prednisolone, 20β-dihydroprednisolone, and prednisone, the latter at lower concentrations, up to 33 days after the first dosing. Higher analyte levels were detected in bulls even after correction for dilution in the urine. Prednisolone concentrations below 5 ng/ml were determined in half of the samples collected at 19 days, and in all the samples obtained 26 and 33 days after the first administration. No measurable concentrations of prednisolone or its metabolites were found in the samples collected before the treatment, while cortisol and cortisone levels lower than the respective LOQs were observed upon treatment.
CONCLUSIONS
The present study confirms the criticism of the coarse quantitative approach currently adopted to ascertain illegal prednisolone administration in cattle. As previously shown for growth-promoting treatments of meat cattle, the simultaneous determination of urinary prednisolone, prednisone, 20β-dihydroprednisolone, along with cortisol and cortisone, may represent a more reliable approach to confirm the exogenous origin of prednisolone. Such a strategy would facilitate unequivocal detection of animals treated with prednisolone acetate using a therapeutical protocol, even 3 to 4 weeks after the treatment.
Topics: Adrenal Cortex Hormones; Animals; Cattle; Female; Male; Prednisolone
PubMed: 25267433
DOI: 10.1186/s12917-014-0237-0 -
British Medical Journal Aug 1958
Topics: Arthritis; Arthritis, Rheumatoid; Humans; Prednisolone
PubMed: 13560845
DOI: 10.1136/bmj.2.5091.290 -
Proceedings of the Royal Society of... Jun 1964
Topics: Administration, Cutaneous; Diagnosis; Humans; Liver Cirrhosis; Liver Function Tests; Pathology; Prednisolone; Skin Diseases; Syndrome
PubMed: 14190879
DOI: No ID Found -
British Medical Journal May 1968
Topics: Adult; Asthma; Female; Humans; Male; Middle Aged; Prednisolone
PubMed: 5648313
DOI: 10.1136/bmj.2.5603.493-b -
British Medical Journal Oct 1960
Topics: Dexamethasone; Disease; Muscles; Muscular Diseases; Prednisolone
PubMed: 13706530
DOI: 10.1136/bmj.2.5206.1129