Related Experiment Videos
Comparison of growth retarding effects induced by two different glucocorticoids in prepubertal sick children: an
G Aicardi1, S Milani, B Imbimbo
1Istituto di Puericultura e Medicina Neonatale L. Gaslini, Università di Genova, Italy.
Insights
Deflazacort (DFZ) shows less growth interference in children compared to prednisone (PDN). This study found DFZ resulted in significantly less bone age delay and statural age loss, indicating a better growth profile.
Area of Science:
- Pediatric Endocrinology
- Pharmacology
- Rheumatology
Background:
- Cortisol analogues like prednisone (PDN) can interfere with growth in children.
- Deflazacort (DFZ), another cortisol analogue, is hypothesized to have lower growth interference.
- This study compares the growth impact of DFZ versus PDN in pediatric patients.
Purpose of the Study:
- To evaluate if deflazacort (DFZ) affects linear growth less than prednisone (PDN) in children.
- To compare bone age delay and statural age loss between DFZ and PDN treatment groups.
- To assess growth retardation in children treated with these corticosteroids.
Main Methods:
- Interim analysis of a randomized trial involving children aged 3-12 years with connective tissue diseases (CTD) or kidney diseases (KD).
- Patients were allocated to receive either DFZ or PDN.
- Anthropometric measurements and maturity ratings were performed to assess growth parameters.
Main Results:
- The increase in bone age delay over time was significantly less with DFZ (-1.8 mo/yr) compared to PDN (-4.0 mo/yr).
- Statural age delay and loss were significantly greater with PDN (-5.9 mo/yr) than DFZ (-2.4 mo/yr), particularly in taller children.
- Despite higher equivalent doses, DFZ-treated children experienced 2.3-2.5 times less growth retardation than PDN-treated children.
Conclusions:
- Deflazacort (DFZ) demonstrates a significantly lower impact on growth, including bone age and statural age, compared to prednisone (PDN) in pediatric patients.
- DFZ may be a preferable alternative to PDN for managing pediatric conditions where growth is a concern.
- These findings support the use of DFZ in children requiring long-term corticosteroid therapy to minimize growth impairment.
Abstract:
The low interference with growth expected in child for a cortisol analogue, deflazacort (DFZ), prompted us to verify if DFZ could affect growth less than prednisone (PDN). An interim analysis relative to 27 girls and 38 boys (out of 100 expected) aged 3-12 yrs, after a median period of 14 mo.s is reported. Children with connective tissues (CTD) and glomerular disorders (KD) were randomly allocated to DFZ or PDN. Anthropometric measurements and maturity ratings were performed. Mean daily doses of PDN (or DFZ equivalent), from 0.57 to 0.64 mg/kg (DFZ 0.92 to 0.94 mg/kg) to induce control and from 0.19 to 0.39 mg/kg (DFZ 0.34 to 0.36 mg/kg) to maintain disease under control were given in CTD and KD, respectively. The increase in bone age delay over time was significantly greater than for PDN (-4.0 mo/yr) than DFZ (-1.8 mo/yr) in the overall group. The increases in statural age delay and loss over time were significantly greater than for PDN (-5.9 and -5.9 mo/yr) than DFZ (-2.4 and -2.4 mo/yr), only in children with "taller" midparents. Although doses of DFZ 1.1-1.8 times those of PDN were given, growth retardation in PDN-treated children was nevertheless 2.3-2.5 times that in DFZ-ones.