title: Comparison of two glucocorticoid preparations (deflazacort and prednisone) in the treatment of immune-mediated diseases.
abstract: Different glucocorticoid preparations modify the immune reaction in different ways. In this paper, the therapeutic efficacy of two glucocorticoids, deflazacort (DFZ) and prednisone (PDN), are discussed in relation to a group of 30 patients with systemic lupus erythematosus (n = 12) or rheumatoid arthritis (n = 18). The disease sub-groups were divided into two arms, one of which was treated with DFZ and one with PDN in a double-blind protocol. The results of this study indicate that DFZ and PDN induced a clinical remission within 1 month which was maintained until the 6th month. Nevertheless, certain immunological modifications, including a significant reduction of the circulating T lymphocyte level and of the CD4/CD8 ratio, which was between 1 and 1,5 during the DFC treatment and between 1 and 2 during the PDN treatment, are more pronounced and more stable with DFZ than with PDN. Moreover, DFZ has a smaller effect on calcium and glucose metabolism than PDN since the serum glucose and calcium level of patients treated with PDN increased respectively from 90 up to 130 mg/dl and from 9,5 to 11,5 mg/dl whereas those of patients treated with DFC remained within the normal range. These findings indicate that DFZ may have advantages over PDN in the treatment of immune-mediated diseases.
authors.affiliation: Department of Internal Medicine, Clinical Methodology, University of Genoa, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Scudeletti
authors.forename: F
authors.initials: F
authors.lastname: Puppo
authors.forename: L
authors.initials: L
authors.lastname: Lanza
authors.forename: L
authors.initials: L
authors.lastname: Mantovani
authors.forename: O
authors.initials: O
authors.lastname: Bosco
authors.forename: A
authors.initials: A
authors.lastname: Iudice
authors.forename: B
authors.initials: B
authors.lastname: Imbimbo
authors.forename: F
authors.initials: F
authors.lastname: Indiveri
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000276:immunology; D016516:CD4-CD8 Ratio / Q000187:drug effects; D004311:Double-Blind Method; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy* / Q000276:immunology; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use*; D011282:Pregnenediones / Q000627:therapeutic use*; D012074:Remission Induction
chemical_list: D000893:Anti-Inflammatory Agents; D011282:Pregnenediones; C021988:deflazacort; D011241:Prednisone