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Effects of deflazacort vs. methylprednisone: a randomized study in kidney transplant patients

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Abstract

Metabolic effects of deflazacort vs. methylprednisone were studied in prepubertal patients after kidney transplantation. Thirty-one patients participated: 15 received deflazacort and 16 remained on methylprednisone. The study started at a mean of 2.1 years after transplantation, when patients were randomized to either continue with methylprednisone or switch to deflazacort. Height velocity increased more in the deflazacort than in the methylprednisone group only during the first 2 years: 5.4 ± 0.5 vs. 3.5 ± 0.3 cm/year, and 4.2 ± 0.8 vs. 2.2 ± 0.4 cm/year p = 0.007, [by two-way analysis of variance (ANOVA)]. After 2 and 3 years, the number of patients who were overweight increased in the methylprednisone group and decreased in the deflazacort group; p < 0.01. Lean body mass increased more in the deflazacort than in the methylprednisone group (p = 0.003). Fat body mass increased only in the methylprednisone group (p < 0.01). Total cholesterol and low-density-lipoprotein (LDL) cholesterol increased in the methylprednisone group (p < 0.05 and p < 0.01, respectively). Total and LDL cholesterol were reduced (p < 0.01 and p < 0.001, respectively), whereas high-density-lipoprotein (HDL) cholesterol increased (p < 0.001) during deflazacort therapy. Lumbar spine bone mineral density (BMD) decreased in both groups, but total skeleton BMD decreased only in the methylprednisone group (p < 0.001). Finally, normal glucose/insulin ratio, defined as > 7, was associated (p < 0.05) with the deflazacort group. Our data suggest that deflazacort therapy might improve linear growth and lean body mass and prevent excessive bone loss and fat accumulation. It also leads to an improvement in lipoprotein profile without reduction in insulin sensitivity.

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Acknowledgements

We thank Dr. Enrique Soriano and his group (Comité de Investigación Clínica, Hospital Italiano de Buenos Aires), and Verónica Alfonso for secretarial assistance.

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Authors and Affiliations

  1. Sección Trasplante Renal Pediátrico, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

    Jorge R. Ferraris

  2. Departamento de Pediatría, Universidad de Buenos Aires, Buenos Aires, Argentina

    Jorge R. Ferraris

  3. Sección de Endocrinología Pediátrica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

    Titania Pasqualini & Guillermo Alonso

  4. Departamento de Análisis Clínicos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

    Susana Legal & Patricia Sorroche

  5. Servicio de Endocrinología y Medicina Nuclear, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

    Ana M. Galich

  6. División Endocrinología National Research Council (CONICET), Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina

    Héctor Jasper

  7. Avenida Santa Fé 2664. 1° A, Buenos Aires, 1425, Argentina

    Jorge R. Ferraris

Authors
  1. Jorge R. Ferraris
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  2. Titania Pasqualini
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  3. Guillermo Alonso
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  4. Patricia Sorroche
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  5. Ana M. Galich
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  6. Héctor Jasper
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Consortia

The Deflazacort Study Group

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Correspondence to Jorge R. Ferraris.

Additional information

Deflazacort Study Group: José Oyhamburu, José Ramirez (Hospital Italiano); Horacio Repetto, Laila Rodriguez Rilo (Instituto Nefrológico Buenos Aires, Argentina); Amalia Turconi, Norma Delgado (Hospital Garraham, Buenos Aires, Argentina); Ernesto Sojo, María Caletti (Unidad de Nefrología Pediátrica, Buenos Aires, Argentina); Mariana Gutierrez, Patricia Bedecarras (Hospital Ricardo Gutierrez, Buenos Aires, Argentina).

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Ferraris, J.R., Pasqualini, T., Alonso, G. et al. Effects of deflazacort vs. methylprednisone: a randomized study in kidney transplant patients. Pediatr Nephrol 22, 734–741 (2007). https://doi.org/10.1007/s00467-006-0403-0

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