Deflazacort: a glucocorticoid with few metabolic adverse effects but important immunosuppressive activity

Deflazacort (DFZ) is a synthetic glucocorticoid that has few adverse effects on glucose and calcium metabolism and fewer deleterious effects on the neuronal population. Therefore, it may have a crucial role in the treatment of patients with autoimmune disorders associated with central nervous system or metabolic affectations. To date, the pharmacologic safety profile of DFZ is considered similar to that of other glucocorticoids. Nevertheless, cumulative clinical and laboratory evidence suggests that DFZ has, in fact, greater immunosuppressive activity than was previously thought. Therefore, it is possible that DFZ increases the risk of acquiring opportunistic infection compared with other synthetic glucocorticoids. Additional pharmacologic studies are needed to fully establish the immunosuppressive potency of DFZ and, consequently, to determine the appropriate ratio of bioequivalence in humans.