|
Conventional oral steroids like prednisolone have various adverse effects both during short-term and long-term use. Hence a search for an alternative oral steroid with fewer side-effects is underway throughout the world. Deflazacort, an oxazoline derivative, is a step in this direction. The number of large randomized trials using deflazacort for steroid-responsive disorders in children is limited. Use of deflazacort has been explored largely in patients with Duchene’s muscular dystrophy. Preliminary data suggest reduced osteoporosis, lesser growth retardation and weight gain with use of deflazacort, as compared to other steriods. In view of the limited data demonstrating superiority of deflazacort over the available oral steroids and its prohibitive cost, it is early to advocate widespread use of this drug in children. Deflazacort is a synthetic glucocorticoid. Based on data obtained from various trials (including double-blind crossover studies, paired patient studies, and between-patient studies) involving 160 patients, the potency ratio of deflazacort vs. prednisolone was estimated to be 1.28.It has been suggested that 6 mg of deflazacort has approximately the same anti-inflammatory potency as 5 mg prednisolone; although dosage ratios of 1:1.2 to 1:1.5 have also been reported across individual disease conditions such as rheumatoid arthritis,asthma and polymyalgia rheumatic in adult patients. Deflazacort is well absorbed after oral administration and converted to an active metabolite (D 21-OH) by plasma esterase’s. Peak plasma concentrations are achieved in 1.5-2 h and elimination plasma half life is 1.1-1.9 h. It is 40% protein-bound and is mainly (70%) excreted via the kidneys. Fecal excretion contributes to 30% of drug elimination. It has no affinity for transcortin (corticosteroid-binding-globulin). Randomized double-blind trials in children have demonstrated that deflazacort achieved disease control similar to prednisolone and a more pronounced and stable reduction in the number of circulating T lymphocytes and in CD4/CD8 ratio suggesting its advantage in immune-mediated diseases. More studies are awaited to clarify its role in treating such chronic inflammatory disorders. Deflazacort, a derivative of prednisolone appears promising. However, controlled clinical trials involving large number of children on deflazacort therapy for prolonged periods are still lacking. It is still early to advocate deflazacort for DMD as its superiority over the time-tested steroid, viz. prednisolone is still not established. In juvenile idiopathic arthritis, asthma and idiopathic thrombocytopenic purport, it is perhaps as efficacious as prednisolone. In limited trials in children with nephritic syndrome, it has been shown to be more efficacious than prednisolone in inducing remission and reducing relapse rates. Till date Deflazacort appears to be more advantageous in children with chronic renal failure as dose adjustments are not needed. It may have a beneficial effect on bone mineral density, weight gain and growth velocity but warrants further evidence. From the available evidence, it is still premature to label deflazacort as superior to conventional steroids for various conditions both in terms of efficacy and safety profile. Vikas, for information on Pharma Franchise, Moxifloxacin,Pharma Company in Uttrakhand, Ortho Company in India,Deflazacort,Calcitriol,Acelofenac and Paracetamol with Serratiopeptidase,Tramadol with Paracetamol, Amoxcilin with Potassium Clavulanate, Clindamycin Capsule and Injection,Pharmaceutiicals Company in India,Vitamin D3 Injection, Pregabalin with Metylcobalamin and Rabeprazole with Domperidone.Please visit our site:http://www.plenuspharma.com
Related Articles -
Deflazacort, Acelofenac and Paracetamol with Serrrtiopeptidase,
|
