title: Bolus administration of steroid therapy is more favorable than the conventional use in preventing decrease of bone density and the increase of body fat percentage in patients with inflammatory bowel disease.
abstract: BACKGROUND
  The effects of short course of corticosteroids on the metabolic processes and bone formation has not been well studied. Our aim was to compare the efficacy, the side effects and the bone and lipid metabolisms in IBD patients using bolus or conventional tapering of methylprednisolone for 12 weeks.
  
  
  METHODS
  Nineteen IBD patients received intravenous methylprednisolone of 1mg/kg for 5 days tapered by 4 mg per week. Patients were prospectively randomized in two groups. In "conventional" group (I) steroids were given daily. In "pulse" group (II) weekly doses of steroids were given on special days of the week. The body mass index (BMI) was measured before and after the corticosteroid therapy. Blood samples were collected to assess glucose level, electrolytes, cholesterol and triglyceride levels, inflammatory parameters, cortisol, osteocalcin and crosslaps values. Total body composition analysis was performed at the beginning and at the end of the steroid therapy.
  
  
  RESULTS
  In Group I, BMI increased, total body bone density decreased significantly at the end of the steroid therapy. Body fat percent showed a tendency to be higher at the end of steroid therapy in Group I. Cholesterol level increased significantly in Group I patients. The decrease in serum cortisol level was more remarkable in Group I vs. Group II after steroid therapy. Less side-effect occurred in Group II vs. Group I.
  
  
  CONCLUSIONS
  Our results suggest that bolus tapering of corticosteroids may have more favorable short term outcome than conventional tapering that may revolutionize steroid therapy in IBD.
authors: First Department of Medicine, University of Szeged, Szeged, Hungary. Electronic address: farkas.klaudia@gmail.com.
authors: Klaudia
authors: K
authors: Farkas
authors: First Department of Medicine, University of Szeged, Szeged, Hungary.
authors: Anita
authors: A
authors: Bálint
authors: First Department of Medicine, University of Szeged, Szeged, Hungary.
authors: Zsuzsanna
authors: Z
authors: Valkusz
authors: First Department of Medicine, University of Szeged, Szeged, Hungary.
authors: Zoltán
authors: Z
authors: Szepes
authors: First Department of Medicine, University of Szeged, Szeged, Hungary.
authors: Ferenc
authors: F
authors: Nagy
authors: Department of Medical Physics and Informatics, University of Szeged, Szeged, Hungary.
authors: Mónika
authors: M
authors: Szűcs
authors: First Department of Medicine, University of Szeged, Szeged, Hungary.
authors: Renáta
authors: R
authors: Bor
authors: First Department of Medicine, University of Szeged, Szeged, Hungary.
authors: Tibor
authors: T
authors: Wittmann
authors: First Department of Medicine, University of Szeged, Szeged, Hungary.
authors: Tamás
authors: T
authors: Molnár
mesh_terms: D000273:Adipose Tissue / Q000187:drug effects / Q000378:metabolism*; D000328:Adult; D015992:Body Mass Index; D015519:Bone Density / Q000187:drug effects*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy* / Q000378:metabolism; D050356:Lipid Metabolism / Q000187:drug effects*; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D008775:Methylprednisolone
keywords: Bolus administration; Inflammatory bowel disease; Metabolism; Steroid therapy