Administration of methylprednisolone pulse in chronic arthritis in children.

The authors retrospectively evaluated the results of methylprednisolone pulse in 15 children with chronic arthritis (JRA - 13 cases, spondyloarthropathy - 2 cases). Methylprednisolone succinate was administered at a dosage of 700 mg/m2 by an I.V. infusion pump on 3 consecutive days. A dramatic clinical improvement was obtained in 12/15 cases at day 4. In 7 cases, multiple pulses (between 2 and 8 courses) were administered to obtain better control of the disease and a decrease in the daily dosage of corticosteroids. Only mild and transient side effects were observed; moreover, previous corticosteroid side effects (especially growth retardation) decreased. The duration of clinical benefit was between 2 weeks and 10 months. Disease modifying agents should always be associated with MP pulse therapy to obtain a prolonged response.