Department of Neurology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
Eur Neurol. 2012;68(2):117-21. doi: 10.1159/000338474. Epub 2012 Jul 11.
We previously reported no difference in the efficacies of high-dose alternate-day (ADT) and daily-dose (DDT) prednisolone therapies in myositis patients, but that the incidence of side effects was lower in the former. The aim of the present study was to compare the long-term outcomes of both treatments in polymyositis patients.
We compared clinical courses, efficacies, adverse reactions, and outcomes of 115 consecutive, biopsy-proven polymyositis patients treated between 1970 and 2008 with ADT (32 patients) or DDT (83 patients).
Mean onset ages, disease severity, incidences of malignancy, and response rates did not differ between the ADT and DDT groups. Adverse reactions (incidence of diabetes) were significantly higher in the DDT group. In this group, the incidences of hyperlipidemia, infection, hypertension, and psychiatric symptoms were also slightly higher, but not significantly so. The 20-year survival rate of the ADT group (68%) was significantly higher (p = 0.0112) than that of the DDT group (37%).
ADT might be useful as an initial treatment option for polymyositis.
我们之前报告称，高剂量隔日（ADT）和每日剂量（DDT）泼尼松龙疗法在肌炎患者中的疗效没有差异，但前者的副作用发生率较低。本研究的目的是比较两种治疗方法在多发性肌炎患者中的长期疗效。
我们比较了 1970 年至 2008 年间连续收治的 115 例经活检证实的多发性肌炎患者的临床病程、疗效、不良反应和结局，这些患者接受 ADT（32 例）或 DDT（83 例）治疗。
ADT 组和 DDT 组的平均发病年龄、疾病严重程度、恶性肿瘤发生率和缓解率无差异。DDT 组不良反应（糖尿病发生率）较高。该组的血脂异常、感染、高血压和精神症状发生率也略高，但无统计学意义。ADT 组 20 年生存率（68%）显著高于 DDT 组（37%）（p = 0.0112）。
ADT 可能是治疗多发性肌炎的一种有效初始治疗选择。
