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Effects of long-term maintenance therapy with a new glucocorticoid, deflazacort, on mineral metabolism and statural growth

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Summary

Deflazacort was substituted for Prednisone (based on the equivalence 1 mg Prednisone equals 1.2 mg Deflazacort), during maintenance glucocorticoid therapy in 9 children, 5 with renal diseases and 4 with connective tissue or immunoproliferative disorders. Six patients received 0.26–0.35 mg/kg body weight (B.W.)/day and 3 0.48–1.2 mg/kg B.W. on alternate days, for 10–16 months. Except for a child with chronic juvenile arthritis, who was also unresponsive to Prednisone, the therapeutic effects of Deflazacort were excellent. Steroid side effects present in 8 patients decreased or disappeared. Plasma Ca, P, Mg, creatinine, alkaline phosphatase, iPTH(1-34), urinary excretion of Ca, cAMP, and TRP remained normal. Plasma iPTH(1-84) remained normal in 5 children; in the other 4 patients it increased from normal to slightly elevated values. On Deflazacort, plasma calcidiol concentrations were within the normal range in 6/8 patients prescribed daily doses of vitamin D2 (1,600–2,400 IU) or calcidiol (20 μg). Plasma 1,25(OH)2D levels monitored in 5 children were also normal. The osteoporosis, evaluated on the tibial cortico-diaphyseal ratio and the trabecular aspect of bone radiograms, present in 5 patients, persisted in 1 and improved in the others. On Deflazacort, statural growth proceeded normally in all subjects, with a modest acceleration of growth velocity in 3 children. These results seem encouraging for extending clinical trials with Deflazacort to the active phase of pediatric diseases requiring glucocorticoid.

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Authors and Affiliations

  1. CNRS UA.583 Laboratoire des Tissus Calcifiés, Hôpital des Enfants-Malades, Tour technique 6ème Etage, 149, rue de Sèvres, 75743 Paris Cédex 15, France

    Sonia Balsan, Dominique Stéru, Agnès Bourdeau, Régine Grimberg & Gérard Lenoir

  2. Department of Pediatrics, Hôpital des Enfants-Malades, Paris, France

    Sonia Balsan, Dominique Stéru, Agnès Bourdeau, Régine Grimberg & Gérard Lenoir

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  1. Sonia Balsan
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  2. Dominique Stéru
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  5. Gérard Lenoir
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Balsan, S., Stéru, D., Bourdeau, A. et al. Effects of long-term maintenance therapy with a new glucocorticoid, deflazacort, on mineral metabolism and statural growth. Calcif Tissue Int 40, 303–309 (1987). https://doi.org/10.1007/BF02556690

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  • DOI: https://doi.org/10.1007/BF02556690

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