Intermittent prednisone therapy in Duchenne muscular dystrophy: a randomized controlled trial.
BACKGROUND
Prednisone treatment is used to prolong ambulation in patients with Duchenne muscular dystrophy (DMD). However, since severe adverse effects often accompany prednisone treatment, it is debatable whether the benefits of prednisone treatment outweigh its adverse effects.


OBJECTIVE
To study the effects of prednisone on muscle function and to determine the extent of steroid-related adverse effects and their influence on the quality of life of ambulant patients with DMD.


METHODS
A randomized, placebo-controlled, crossover trial with 6 months of treatment: prednisone or placebo (0.75 mg/kg daily) during the first 10 days of each month. After a washout period of 2 months, patients received the other regimen for an additional 6 months.


METHODS
University hospital and rehabilitation center in the Netherlands.


METHODS
Seventeen ambulant patients with DMD aged 5 to 8 years.


METHODS
Change in muscle function assessed by timed functional testing: running 9 m, climbing 4 standard-sized stairs, and rising from the floor to a standing position.


RESULTS
The increase in time needed to run 9 m (P = .005) and to climb 4 standard-sized stairs (P = .02) was significantly lower during the prednisone period.


CONCLUSIONS
Prednisone slowed deterioration of muscle function and muscle force in ambulant patients with DMD. Although adverse effects were present, patient quality of life was not affected. Therefore, short-term prednisone treatment can be recommended to preserve motor functions in ambulant patients with DMD.
Beenakker
Ernesto A C
EA
Department of Neurology, University Hospital Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands. e.a.c.beenakker@neuro.azg.nl
Fock
Johanna M
JM
Van Tol
Marja J
MJ
Maurits
Natalia M
NM
Koopman
Hendrik M
HM
Brouwer
Oebele F
OF
Van der Hoeven
Johannes H
JH
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000187:drug effects; D020388:Muscular Dystrophy, Duchenne / Q000188:drug therapy*; D009460:Neurologic Examination; D011241:Prednisone / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D011241:Prednisone