Effectiveness of a hybrid corticosteroid treatment regimen on refractory childhood XXXX and a review of other corticosteroid treatments.

@entity1 @entity1667 @entity410 @entity12924 @entity739 @entity302 @entity617 @entity288
BACKGROUND: Many different corticosteroid treatment schedules have been used in order to treat refractory @entity302 with encouraging effects on @entity410 reduction in many @entity302 . OBJECTIVE: The objective is to report our experience with a hybrid treatment regimen for @entity410 in @entity1 with @entity302 other than West and @entity12924 . We hypothesized that a pulse of @entity288 effectively reduces @entity410 while low-dosage maintenance treatment reduces side effects. The results are compared with results from a review of reported corticosteroid and ACTH treatments. METHODS: In this retrospective observational study, 26 @entity1 diagnosed with @entity302 with @entity410 other than @entity739 and @entity12924 were eligible for a treatment regimen consisting of three days intravenous @entity1667 (20  mg per kilogram per day) followed by twelve weeks oral @entity617 (0.5  mg per kilogram on alternate days), concluded with a taper phase. Data on effectiveness and side effects were obtained. End-points were the percentages of @entity1 who became @entity410 free or responded well. RESULTS: Twenty-one @entity1 received the study treatment. Nine (43%) responded well and 6 (29%) became @entity410 free. All but one @entity1 had a relapse of @entity410 . Four @entity1 had reversible adverse effects. Data extracted from the literature were consistent with a good response in 48% of 192 @entity1 treated with different corticosteroids and in 69% of 103 @entity1 treated with ACTH. CONCLUSION: This new hybrid therapy of a pulse of intravenous @entity1667 and alternate day oral @entity617 is effective with a favourable side effect profile. Results on efficacy and safety justify a randomized controlled trial.
