A comparison of daily and alternate-day prednisone therapy in the treatment of Duchenne muscular dystrophy.
We previously reported the results of a randomized, double-blind 6-month trial of prednisone therapy in which 102 boys aged 5 to 15 years with Duchenne muscular dystrophy received daily doses of 1.5 and 0.75 mg/kg per day and were compared with those receiving placebo. The strength and function in both prednisone-treated groups improved equally and were significantly better than in the placebo group. To compare alternate-day and daily dosing of prednisone with respect to benefits and adverse side effects, the placebo group was started on alternate-day prednisone therapy, and the treatment group regimens were changed to equivalent doses of alternate-day prednisone without breaking the double-blind nature. At the end of 6 months, the group that was changed from daily to alternate-day therapy had declined in strength back to levels observed 12 months previously, at the start of daily therapy. The group in which alternate-day therapy was started showed a significant improvement in strength at 3 months, similar in magnitude to the response of boys treated with daily therapy. However, their strength declined significantly in the subsequent 3 months compared with boys who received daily therapy. The frequency of side effects was not significantly different for alternate-day therapy compared with daily therapy. We conclude that alternate-day prednisone therapy effectively increases strength but does not sustain the improvement to the same extent as daily therapy or mitigate side effects.
Fenichel
G M
GM
Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37212.
Mendell
J R
JR
Moxley
R T
RT
Griggs
R C
RC
Brooke
M H
MH
Miller
J P
JP
Pestronk
A
A
Robison
J
J
King
W
W
Signore
L
L
D000293:Adolescent; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D006801:Humans; D008297:Male; D009136:Muscular Dystrophies / Q000188:drug therapy*; D011241:Prednisone / Q000008:administration & dosage* / Q000009:adverse effects
D011241:Prednisone