[Effectiveness and side-effects of long-term treatment with glucocorticoids in patients with juvenile rheumatoid arthritis].
The authors studied the response to and side effects of long-term glucocorticoid (GC) therapy of systemic juvenile rheumatoid arthritis (SJRA). GC were given to 24 girls and 9 boys at the age of 4 to 15 years with classic SJRA in a mean dose 1.6 +/- 0.13 mg/kg (24.0 +/- 0.55 mg/day) for 6.3 +/- 0.55 years, on the average. Mean duration of the disease was 7.1 +/- 0.55 years. 94% of the patients had lymphaticohypolastic constitution. Long-term GC monotherapy in a dose 0.2-0.5 mg/kg/day failed to control a SJRA course and to produce an immunosuppressive effect while side effects were severe: inhibition of activity of the hypothalamohypophysioadrenal system and resultant hormone dependence (100%), Cushing's syndrome (97%), nanism (85%), osteoporosis (64%), secondary infections (58%), aseptic necrosis of heads of the femur (52%). Oral GC treatment is not effective as first-line therapy of SJRA. It should be used as adjuvant to immunodepressants. Intraarticular and/or intravenous administration is preferable.
Alekseev
E I
EI
Shakhbazian
I E
IE
Ulybina
O V
OV
Khudoleeva
E Iu
EIu
D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001171:Arthritis, Juvenile / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D011239:Prednisolone / Q000008:administration & dosage / Q000627:therapeutic use*; D013995:Time; D013997:Time Factors
D000893:Anti-Inflammatory Agents; D011239:Prednisolone