Practice parameter: corticosteroid treatment of Duchenne dystrophy: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society.
Practice parameter: corticosteroid treatment of Duchenne dystrophy: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society.
American Academy of Neurology - Medical Specialty Society
Summary,
GUIDELINE OBJECTIVE(S)
To review available evidence on corticosteroid treatment of boys with Duchenne dystrophy
TARGET POPULATION
Boys with Duchenne muscular dystrophy
INTERVENTIONS AND PRACTICES CONSIDERED
1. Prednisone/prednisolone
* Daily dosing
* Reductions in daily dose
* Alternate day dosing (not recommended)
* Cyclical dosing (not recommended)
2. Deflazacort (an oxazolone analogue of prednisone)
3. Azathioprine (Imuran) immunosuppressive therapy (not recommended)
4. Ongoing monitoring of the benefits and side effects of corticosteroid therapy
* Timed function tests
* Pulmonary function tests (forced vital capacity [FVC])
* Twenty-four hour urinary excretion of creatine (a surrogate measure of muscle mass)
MAJOR OUTCOMES CONSIDERED
* Effects of corticosteroid treatment on muscle strength, muscle function, functional ability, pulmonary function, 24-hour excretion of creatinine, and progression of weakness
* Side effects of corticosteroids
