title: Comparative study of the effect of a daily steroid regimen versus a weekly oral pulse steroid regimen on morphological changes, blood sugar, bone mineral density and suprarenal gland activity.
abstract: BACKGROUND
  The most serious side effects of systemic steroids include osteoporosis and suprarenal suppression. Many steroid regimens have been suggested to minimize these side effects; one of them is oral steroid pulse therapy.
  
  
  OBJECTIVE
  To compare the side effects of a daily oral steroid regimen versus a weekly oral steroid pulse regimen on bone mineral density and suprarenal suppression.
  
  
  METHODS
  Thirty patients with different skin diseases were divided into two groups: 15 for oral daily steroids (ODS) (group 1) and 15 for weekly oral pulse steroids (WOPS) (group 2). They were evaluated for bone mineral density (measured by DEXA) and suprarenal suppression (measured by serum cortisol level), morphological changes and blood sugar. Treatment was continued for 6 months to 3 years.
  
  
  RESULTS
  Cushingoid features in group 1 were observed in 73%, yet they were not detectable in group 2. Disturbed blood sugar in group 1 was 33% and 0% in group 2. The serum cortisol level was lower in patients on ODS than those on WOPS. The effect of WOPS on bone mineral density was very limited in comparison with the ODS.
  
  
  CONCLUSIONS
  Weekly oral steroid pulse therapy induces no significant bone loss and no suprarenal suppression and can be an alternative option in the treatment of chronic disorders requiring long-term oral steroid therapy.
authors.affiliation: Departments of Dermatology, Cairo University, Cairo, Egypt.
authors.forename: Mohammad A
authors.initials: MA
authors.lastname: El-Darouti
authors.forename: Heba M
authors.initials: HM
authors.lastname: Mashaly
authors.forename: Eman
authors.initials: E
authors.lastname: El-Nabarawy
authors.forename: Amira M
authors.initials: AM
authors.lastname: El-Tawdy
authors.forename: Marwa M
authors.initials: MM
authors.lastname: Fawzy
authors.forename: Dorreya S E
authors.initials: DS
authors.lastname: Salem
authors.forename: Khaled M H
authors.initials: KM
authors.lastname: El-Kaffas
authors.forename: Dalia A M
authors.initials: DA
authors.lastname: El Sayed
mesh_terms: D000284:Administration, Oral; D000311:Adrenal Glands / Q000187:drug effects*; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000187:drug effects*; D015519:Bone Density / Q000187:drug effects*; D003480:Cushing Syndrome / Q000139:chemically induced; D003920:Diabetes Mellitus / Q000139:chemically induced; D004334:Drug Administration Schedule; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D006943:Hyperglycemia / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D005938:Glucocorticoids; D011241:Prednisone; D006854:Hydrocortisone