-
Annals of Clinical and Translational... Dec 2023Duchenne muscular dystrophy (DMD) is a neuromuscular disorder in which many patients also have neurobehavioral problems. Corticosteroids, the primary pharmacological...
OBJECTIVE
Duchenne muscular dystrophy (DMD) is a neuromuscular disorder in which many patients also have neurobehavioral problems. Corticosteroids, the primary pharmacological treatment for DMD, have been shown to affect brain morphology in other conditions, but data in DMD are lacking. This study aimed to investigate the impact of two corticosteroid regimens on brain volumetrics in DMD using magnetic resonance imaging (MRI).
METHODS
In a cross-sectional, two-center study, T1-weighted MRI scans were obtained from three age-matched groups (9-18 years): DMD patients treated daily with deflazacort (DMDd, n = 20, scan site: Leuven), DMD patients treated intermittently with prednisone (DMDi, n = 20, scan site: Leiden), and healthy controls (n = 40, both scan sites). FSL was used to perform voxel-based morphometry analyses and to calculate intracranial, total brain, gray matter, white matter, and cerebrospinal fluid volumes. A MANCOVA was employed to compare global volumetrics between groups, with site as covariate.
RESULTS
Both patient groups displayed regional differences in gray matter volumes compared to the control group. The DMDd group showed a wider extent of brain regions affected and a greater difference overall. This was substantiated by the global volume quantification: the DMDd group, but not the DMDi group, showed significant differences in gray matter, white matter, and cerebrospinal fluid volumes compared to the control group, after correction for intracranial volume.
INTERPRETATION
Volumetric differences in the brain are considered part of the DMD phenotype. This study suggests an additional impact of corticosteroid treatment showing a contrast between pronounced alterations seen in patients receiving daily corticosteroid treatment and more subtle differences in those treated intermittently.
Topics: Humans; Child; Adolescent; Muscular Dystrophy, Duchenne; Cross-Sectional Studies; Adrenal Cortex Hormones; Brain; Prednisone
PubMed: 37822297
DOI: 10.1002/acn3.51922 -
Bulletin of the NYU Hospital For Joint... 2012Glucocorticoids form a mainstay of therapy for rheumatoid arthritis (RA) and other conditions since they exert strong anti-inflammatory, immunosuppressive, and... (Review)
Review
Glucocorticoids form a mainstay of therapy for rheumatoid arthritis (RA) and other conditions since they exert strong anti-inflammatory, immunosuppressive, and disease-modifying therapeutic effects. However, there is increasing awareness of the potential for these drugs to produce adverse effects. Therefore, improvement of the glucocorticoid benefit-risk ratio represents both a current need and an ongoing challenge. The development of recommendations to implement a more effective and safer use of these important drugs is one useful path to pursue. An additional avenue is the development of innovative glucocorticoids or glucocorticoid receptor ligands. Also, treatment with conventional glucocorticoid preparations currently available to clinicians may be improved. The most advanced development in the latter regard is a novel chronotherapeutic prednisone formulation called delayed- release (DR) or modified-release prednisone. The CAPRA (Circadian Administration of Prednisone in Rheumatoid Arthritis) studies confirmed that optimizing the timing of GC administration improves the benefit-risk ratio of long- term low dose glucocorticoid treatment in patients with rheumatoid arthritis. DR prednisone has been approved in 16 European countries as well as Australia and Israel. Very recently, DR prednisone was also approved in the United States to treat rheumatologic conditions such as RA, polymyalgia rheumatica and psoriatic arthritis, as well as respiratory conditions such as COPD and asthma.
Topics: Antirheumatic Agents; Arthritis, Rheumatoid; Chronotherapy; Glucocorticoids; Humans; Prednisone; Treatment Outcome
PubMed: 23259655
DOI: No ID Found -
Postgraduate Medical Journal Mar 1968The case history is detailed of a 55-year-old woman who was investigated for persistent pyrexia and anaemia. A liver biopsy specimen showed an unusual lesion of the...
The case history is detailed of a 55-year-old woman who was investigated for persistent pyrexia and anaemia. A liver biopsy specimen showed an unusual lesion of the small intrahepatic arteries. Many of these vessels showed circumferential replacement of their adventitial coat by a non-caseating granuloma whilst others showed localized granulomata focally interrupting the adventitial coat. The medial and intimal coats of the affected arteries were normal. This was an intrahepatic granulomatous arteriopathy of unknown origin. The patient responded promptly and completely to steroid therapy.
Topics: Female; Granuloma; Hepatic Artery; Humans; Liver Diseases; Middle Aged; Prednisone
PubMed: 5648674
DOI: 10.1136/pgmj.44.509.256 -
Japanese Journal of Clinical Oncology Jul 2020LATITUDE was a randomized, double-blind, international and phase 3 study of abiraterone acetate plus prednisone in patients with high-risk metastatic hormone-naïve... (Randomized Controlled Trial)
Randomized Controlled Trial
Efficacy and safety of abiraterone acetate plus prednisone in Japanese patients with newly diagnosed, metastatic hormone-naive prostate cancer: final subgroup analysis of LATITUDE, a randomized, double-blind, placebo-controlled, phase 3 study.
BACKGROUND
LATITUDE was a randomized, double-blind, international and phase 3 study of abiraterone acetate plus prednisone in patients with high-risk metastatic hormone-naïve prostate cancer. In the first interim analysis of LATITUDE (clinical cutoff date: 31 October 2016), significant prolongation in overall survival and radiographic progression-free survival (co-primary endpoints) was observed when compared with placebo. The results of the Japanese subgroup analysis of LATITUDE first interim analysis were consistent with those of the overall population. In this study, overall survival and safety results from the final analysis of the Japanese subgroup of the LATITUDE study are presented (clinical cutoff date: 15 August 2018).
METHODS
Abiraterone acetate (1000 mg/day) and prednisone (5 mg/day) were administered orally in the abiraterone acetate plus prednisone group, and matching placebos in the placebo group.
RESULTS
Of the 1199 patients included in LATITUDE, 70 constituted the Japanese subgroup (abiraterone acetate plus prednisone: n = 35, placebo: n = 35). Following a median (range) follow-up of 56.6 (2.5, 64.2) months, the median overall survival was not reached in both the treatment arms of the Japanese subgroup (hazard ratio: 0.61; 95% confidence interval: 0.27-1.42; nominal P = 0.2502). A total of 23 deaths (abiraterone acetate plus prednisone: 9 [25.7%], placebo group: 14 [40.0%]) were reported in Japanese subgroup. Grade 3/4 adverse events were reported in 24 (68.6%) and 9 (25.7%) patients in the abiraterone acetate plus prednisone and placebo groups, respectively.
CONCLUSIONS
In this Japanese subgroup analysis, addition of abiraterone acetate plus prednisone to androgen-deprivation therapy demonstrated favorable efficacy and safety outcomes in patients with newly diagnosed, high-risk metastatic hormone-naïve prostate cancer. Survival benefits observed in the Japanese subgroup first interim analysis were sustained long-term and were consistent with the overall population.
Topics: Abiraterone Acetate; Aged; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Double-Blind Method; Humans; Japan; Male; Middle Aged; Neoplasm Metastasis; Prednisone; Prostatic Neoplasms; Survival Analysis
PubMed: 32188988
DOI: 10.1093/jjco/hyaa030 -
Andrology Mar 2017The association between inflammation of the male reproductive system and oligozoospermia has been frequently reported in the clinical work-up of male infertility. To... (Randomized Controlled Trial)
Randomized Controlled Trial
The association between inflammation of the male reproductive system and oligozoospermia has been frequently reported in the clinical work-up of male infertility. To improve sperm parameters in infertile patients with genital inflammation, many phytochemical and nutraceutical drugs are currently being used. However, their use is still empirical and no conclusive data have been provided about their efficacy. The treatment with steroid anti-inflammatory drugs might be useful in reducing inflammation and improving sperm parameters, thus increasing the fertility outcome. The aim of this study was to evaluate if glucocorticoid treatment improves seminal parameters in infertile oligozoospermic patients presenting signs of accessory gland inflammation at genital ultrasound. A total of 90 infertile patients were enrolled in the study. They presented normal testicular volume, normal FSH plasma levels, the presence of various degrees of oligozoospermia, associated with scrotal and trans-rectal ultrasound signs indicative of accessory gland inflammation, but negative microbiological analysis on semen and/or prostatic secretions. Patients were randomly allocated into three groups of treatment, receiving, respectively, 5, 12.5, and 25 mg daily oral Prednisone for one month. Seminal parameters were evaluated at admission and after treatment. In patients undergoing Prednisone treatment at a daily dose of 5 mg we observed a significant increase in total sperm count. At a daily dose of 12.5 mg, Prednisone treatment improved sperm concentration, total sperm count, and the percentage of sperm motility. Twenty-five mg of Prednisone led to significant improvement in all the sperm parameters, except for semen volume. These results clearly demonstrate that Prednisone treatment can significantly improve sperm parameters in a selected population of oligozoospermic patients. These findings suggest that Prednisone treatment should be considered in idiopathic oligozoospermic patients with supposed normal spermatogenesis and accessory gland inflammatory alterations, in order to improve sperm parameters and fertility outcome.
Topics: Adult; Anti-Inflammatory Agents; Humans; Infertility, Male; Inflammation; Male; Middle Aged; Oligospermia; Prednisone; Semen Analysis; Sperm Count; Sperm Motility; Testis; Treatment Outcome; Young Adult
PubMed: 28125168
DOI: 10.1111/andr.12300 -
British Journal of Haematology Jun 2010Glucocorticoids are an integral component of therapy for acute lymphoblastic leukaemia (ALL), but usage differs between cooperative group protocols. All groups use... (Review)
Review
Glucocorticoids are an integral component of therapy for acute lymphoblastic leukaemia (ALL), but usage differs between cooperative group protocols. All groups use glucocorticoids during induction but vary on whether to use dexamethasone or prednisone. Issues to consider in the choice of induction steroid include impact on event-free and overall survival, acute morbidity such as infection risk, diabetes, and behavioural disturbances and long-term complications such as avascular necrosis. It is generally agreed that dexamethasone is the steroid of choice for groups using a delayed intensification phase, but dosing schedules (intermittent versus continuous) vary. There is no consensus on the potential benefit of steroid administration during maintenance therapy. This review will summarize the current available data on steroid use in paediatric ALL, highlighting outcomes as well as major toxicities.
Topics: Adolescent; Child; Child, Preschool; Dexamethasone; Drug Administration Schedule; Glucocorticoids; Humans; Infant; Infant, Newborn; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Prednisone
PubMed: 20408842
DOI: 10.1111/j.1365-2141.2010.08192.x -
International Braz J Urol : Official... 2024This retrospective study aimed to evaluate the effectiveness of low-dose prednisone as a rescue therapy for patients with deteriorating semen parameters following...
OBJECTIVE
This retrospective study aimed to evaluate the effectiveness of low-dose prednisone as a rescue therapy for patients with deteriorating semen parameters following vasovasostomy.
MATERIALS AND METHODS
Electronic medical records were queried at the University of Miami with documented CPT code 55400 (Bilateral Vasovasostomy) between January 2016 and April 2023. Records were then reviewed to identify patients who demonstrated ≥50% decrease in semen parameters, specifically sperm concentration, motility and total motile sperm count. Patients who were treated with 6 weeks of low-dose prednisone were identified, and baseline semen parameters and subsequent changes after prednisone therapy were assessed. A Mann-Whitney U Test was used to compare semen parameter changes before and after prednisone. Adverse effects associated with prednisone were monitored.
RESULTS
A total of 8 patients were identified with deteriorating semen parameters who were treated with 6 weeks of low-dose prednisone. Following prednisone therapy, all patients demonstrated improvements in total motile sperm count (TMSC), with a median improvement of 6 million. The median relative improvement in TMSC was 433%. Sperm concentration and motility also improved compared to post-operative baseline. No adverse effects were reported during the treatment period.
CONCLUSIONS
Low-dose prednisone therapy appears to be a safe and effective intervention for managing deteriorating semen parameters following VV. The observed improvements in TMSC suggest the potential of prednisone to rescue patients with delayed failure after VV. Further research with larger sample sizes is warranted to confirm the safety and efficacy of low-dose prednisone as a rescue therapy in this specific patient population. Optimizing VV outcomes is crucial in male infertility, and further exploration of steroid therapy and innovative biotechnologies is warranted.
Topics: Humans; Male; Semen; Prednisone; Vasovasostomy; Semen Analysis; Retrospective Studies; Infertility, Male; Sperm Count; Sperm Motility
PubMed: 38166223
DOI: 10.1590/S1677-5538.IBJU.2023.0402 -
Molecules (Basel, Switzerland) May 2020Prednisone and prednisolone are steroids widely used as anti-inflammatory drugs. Development of the pharmaceutical industry is currently aimed at introducing...
Prednisone and prednisolone are steroids widely used as anti-inflammatory drugs. Development of the pharmaceutical industry is currently aimed at introducing biotechnological processes and replacing multiple-stage chemical syntheses. In this work we evaluated the ability of bacteria belonging to the genus to biotransform substrates, such as cortisone and hydrocortisone, to obtain prednisone and prednisolone, respectively. These products are of great interest from a pharmaceutical point of view as they have higher anti-inflammatory activity than the starting substrates. After an initial lab-scale screening of 13 strains, to select the highest producers of prednisone and prednisolone, we reported the 200 ml-batch scale-up to test the process efficiency and productivity of the most promising strains. , and gave the Δ1-dehydrogenation products of cortisone and hydrocortisone (prednisone and prednisolone) in variable amounts. In these biotransformations, the formation of products with the reduced carbonyl group in position C of the lateral chain of the steroid nucleus was also observed (i.e., 20β-hydroxy-prednisone and 20β-hydroxy-prednisolone). The yields, the absence of collateral products, and in some cases the absence of starting products allow us to say that cortisone and hydrocortisone are partly degraded.
Topics: Anti-Inflammatory Agents; Biotransformation; Catalysis; Cortisone; Hydrocortisone; Prednisolone; Prednisone; Rhodococcus; Steroids
PubMed: 32392887
DOI: 10.3390/molecules25092192 -
Frontiers in Immunology 2023Hematologic toxicity (HT) is a joint adverse event after CAR-T cells infusion. Some patients experience prolonged hematologic toxicity (PHT), which is challenging to...
INTRODUCTION
Hematologic toxicity (HT) is a joint adverse event after CAR-T cells infusion. Some patients experience prolonged hematologic toxicity (PHT), which is challenging to treat.
METHODS
We collected clinical data from patients with relapsed refractory B-ALL treated with CD19 CAR-T cells. Patients with PHT who did not respond to erythropoietin, platelet receptor agonists, transfusion, or G-CSF and eventually received low-dose prednisone therapy were included in the analysis. We retrospectively analyzed the efficacy and safety of low-dose prednisone on PHT.
RESULTS
Among 109 patients treated with CD19 CAR-T cells, 78.9% (86/109) of patients were evaluated as PHT. Of these, 15 patients had persistent hematological toxicity after infusion (12 were grade 3/4 cytopenia, 12 were trilineage cytopenia and 3 were bilineage cytopenia), 2 developed cytopenia without apparent cause after D28. The initial prednisone dose was 0.5 mg/kg/day, and the median response time was 21 days (7-40 days). The recovery rate of blood count was 100%, and the complete recovery rate ranged from 60% to 66.67%. Especially exciting was that HT recurred in 6 patients after stopping prednisone. They were relieved again after the administration of prednisone. The median follow-up time was 14.97 months (4.1-31.2 months). Twelve-month duration of PFS and OS rates were 58.8% (±11.9%) and 64.7% (±11.6%). We did not observe any other side effects of prednisone apart from drug-controllable hyperglycemia and hypertension.
DISCUSSION
We suggest that low-dose prednisone is a beneficial and tolerable therapy for PHT after CAR-T cells. The trials have been registered at www.chictr.org.cn as ChiCTR-ONN-16009862 (November 14, 2016) and ChiCTR1800015164 (March 11, 2018).
Topics: Humans; Receptors, Chimeric Antigen; Prednisone; Retrospective Studies; Neoplasm Recurrence, Local; Antigens, CD19; Cell- and Tissue-Based Therapy
PubMed: 36999027
DOI: 10.3389/fimmu.2023.1139559 -
European Review For Medical and... Nov 2018To systematically review prednisone induced test results in the prognosis assessment of acute lymphoblastic leukemia in children. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To systematically review prednisone induced test results in the prognosis assessment of acute lymphoblastic leukemia in children.
MATERIALS AND METHODS
Based on the established inclusion and exclusion criteria, studies of prednisone induced test in evaluating the prognosis of childhood acute lymphoblastic leukemia were electronically searched from January 1990 to November 2016 using Pubmed, Embase, The Cochrane Library, Web of Science, WanFang, VIP, and CNKI database. Two independent researchers browsed literature, extracted data and assessed the risk of bias of studies. Meta-analysis was performed using RevMen 5.3 software. A total of 17 articles were included.
RESULTS
Meta-analysis showed that after complete prednisone induced test in children, 5y-EFS, 8y-EFS adverse reactions, persistent remission and relapse were statistically significant differences between the prednisone good response (PGR) and prednisone poor response (PPR). There were statistical significance in T cell immune typing and the initial WBC of the two groups. Prognosis of prednisone good response group is better than prednisone poor response group.
CONCLUSIONS
The prednisone induction test is an important factor in predicting the prognosis of children with ALL.
Topics: Disease-Free Survival; Humans; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Prednisone; Prognosis
PubMed: 30536331
DOI: 10.26355/eurrev_201811_16411