Deleterious effect of prednisolone in HBsAg-positive chronic active hepatitis.
To study the efficacy of corticosteroids in chronic active hepatitis (CAH) positive for hepatitis B surface antigen (HBsAg), we pair-randomized 51 patients to receive either 15 to 20 mg of prednisolone per day or a placebo. After initial remission, the maintenance dosage of prednisolone was 10 mg per day, and the patients were prospectively followed for up to 3 1/2 years. Prednisolone decreased serum bilirubin (P < 0.05) and globulin (P < 0.01) at three months; it delayed other biochemical remission occurring after the second month of medication (P < 0.001); it hastened biochemical relapse (P < 0.0001); and it increased the frequency of complications (P < 0.0001) and the death rate (P < 0.01). We conclude that prednisolone has an overall harmful effect in patients with HBsAg-positive CAH.
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D002908:Chronic Disease; D002986:Clinical Trials as Topic; D005260:Female; D006505:Hepatitis / Q000188:drug therapy*; D006509:Hepatitis B / Q000188:drug therapy; D006514:Hepatitis B Surface Antigens / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000009:adverse effects* / Q000627:therapeutic use; D011446:Prospective Studies; D011897:Random Allocation; D012075:Remission, Spontaneous; D012712:Serum Globulins / Q000032:analysis
D006514:Hepatitis B Surface Antigens; D012712:Serum Globulins; D011239:Prednisolone; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D001663:Bilirubin