What is low-dose corticosteroid therapy in juvenile idiopathic arthritis? A worldwide, questionnaire-based survey.
OBJECTIVE
To determine pediatric rheumatologists' personal definitions of systemic low-dose, long-term (> 4 weeks) corticosteroid therapy of juvenile idiopathic arthritis (JIA).


METHODS
Pediatric rheumatologists from America, the Near East (Israel), Australia and Europe were asked for their personal definition of a low-dose long-term corticosteroid therapy of JIA with the aid a standardized questionnaire.


RESULTS
Of 99 questionnaires returned, 92 were evaluable. The dosage still considered low turned out to be 0.26 +/- 0.14 mg prednisolone/kgBW/day (min-max = 0.04-0.50 mg, n = 92). Higher dosages were indicated from Northern Europe (0.29 +/- 0.12, n = 9), Western Europe (0.42 +/- 0.14, n = 7), Southern Europe (0.30 +/- 0.14, n = 9), Eastern Europe (0.25 +/- 0.14, n = 6) and North America (0.33 +/- 0.17, n = 16) than from Central Europe (0.19 +/- 0.09, n = 43).


CONCLUSIONS
Pediatric rheumatologists' personal definitions of low-dose, long-term corticosteroid therapy vary within a wide range. The reason for these differences and the impact on patients should be investigated. In addition, a generally accepted definition for low-dose, long-term corticosteroid therapy should be developed and subsequently examined in studies.
Michels
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FKH, Abteilung für Kinder- und Jugendrheumatologie Im Spitzerfeld 25 69151 Neckargemünd, Germany.
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D001171:Arthritis, Juvenile / Q000188:drug therapy*; D002648:Child; D003431:Cross-Cultural Comparison; D004305:Dose-Response Relationship, Drug; D006306:Health Surveys; D006801:Humans; D008134:Long-Term Care; D011239:Prednisolone / Q000008:administration & dosage
D000305:Adrenal Cortex Hormones; D011239:Prednisolone