| Popis: |
Deflazacort (DF) and prednisone (PD) were administered to 31 consecutive symptomatic patients with essential mixed cryoglobulinemia (EMC) in a double-blind randomized study lasting 22 months. ‘Loading’ doses given for 3 months were tapered to ‘control-inducing’ and ‘minimum effective’ doses, according to individual needs. The DF to PD mean dose ratio was 1.32-1.34 at ‘loading’ doses, 0.81–1.31 at ‘control-inducing’ doses and 1.14 at ‘minimum effective’ doses. Both steroids significantly improved arthralgias and purpura within 15 days, and this improvement was maintained over the entire study period. Reduction in the CD3+ and CD4+ cell percentages and the CD4+/CD8+ ratio was found in DF and PD patients within 3 months, whereas these effects persisted after tapering in DF patients only. The cryocrit was consistently decreased in both groups, with a minimum between 8 and 12 months. The ESR and 24-hour urine protein excretion also improved in both groups. Drug tolerance was satisfactory, despite the amount and duration of administered doses. However, glucose tolerance and body weight were mainly affected in PD patients. Assessment of the relative potency DF to PD ratio suggests that, in EMC, the mean standard dose unit of DF 6.6–5.7 mg, is clinically equivalent to PD 5 mg. This study shows that, in EMC, DF is clinically as effective as PD, while its immunological effects are more intense and prolonged. |
