Long-term outcome of polymyositis treated with high single-dose alternate-day prednisolone therapy.
BACKGROUND
We previously reported no difference in the efficacies of high-dose alternate-day (ADT) and daily-dose (DDT) prednisolone therapies in myositis patients, but that the incidence of side effects was lower in the former. The aim of the present study was to compare the long-term outcomes of both treatments in polymyositis patients.


METHODS
We compared clinical courses, efficacies, adverse reactions, and outcomes of 115 consecutive, biopsy-proven polymyositis patients treated between 1970 and 2008 with ADT (32 patients) or DDT (83 patients).


RESULTS
Mean onset ages, disease severity, incidences of malignancy, and response rates did not differ between the ADT and DDT groups. Adverse reactions (incidence of diabetes) were significantly higher in the DDT group. In this group, the incidences of hyperlipidemia, infection, hypertension, and psychiatric symptoms were also slightly higher, but not significantly so. The 20-year survival rate of the ADT group (68%) was significantly higher (p = 0.0112) than that of the DDT group (37%).


CONCLUSIONS
ADT might be useful as an initial treatment option for polymyositis.
Department of Neurology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan. uchino@jonan-hospital.or.jp
Makoto
M
Uchino
Satoshi
S
Yamashita
Katsuhisa
K
Uchino
Akio
A
Hara
Tatsuya
T
Koide
Tomohiro
T
Suga
Tomoo
T
Hirahara
En
E
Kimura
Taro
T
Yamashita
Akihiko
A
Ueda
Ryoichi
R
Kurisaki
Junko
J
Suzuki
Shoji
S
Honda
Yasushi
Y
Maeda
Teruyuki
T
Hirano
D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D003920:Diabetes Mellitus / Q000139:chemically induced; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017285:Polymyositis / Q000188:drug therapy*; D011239:Prednisolone / Q000627:therapeutic use*; D015996:Survival Rate; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D011239:Prednisolone