Broyer M, Terzi F, Lehnert A, Gagnadoux M F, Guest G, Niaudet P
Département de Néphrologie Pédiatrique, Hôpital Necker-Enfants Malades, Paris, France.
Pediatr Nephrol. 1997 Aug;11(4):418-22. doi: 10.1007/s004670050308.
Forty patients with steroid-dependent idiopathic nephrotic syndrome (INS), a mean follow-up of 5.5 years, and a mean number of relapses of ten were blindly assigned to either deflazacort (DFZ) (n = 20) or prednisone (PDN) (n = 20) according to a ratio of equivalence of DFZ/ PDN = 0.8. This treatment was given for 1 year. The number of relapses was significantly lower in patients receiving DFZ. After 1 year, 12 remained in remission with DFZ compared with 2 with PDN. Growth velocity was not different in the two groups. Bone mineral content, assessed by quantitative computed tomography of L1 L2 vertebrae, decreased after 1 year by 6% in the DFZ group versus 12% in the PDN group (NS). The mean body weight increase of +3.9 +/- 4.1 kg in the PDN group was higher than that of the DFZ group, +1.7 +/- 2.8 kg (P = 0.06). Cushingoid symptoms tended to be less after 12 months in the DFZ group. In conclusion, this study shows that DFZ was more effective than PDN in limiting relapses in steroid-dependent INS, and that cushingoid symptoms, weight gain, and decrease in bone mineral content tended to be less marked with this drug than with PDN.
40例依赖类固醇的特发性肾病综合征（INS）患者，平均随访5.5年，平均复发次数为10次，根据地夫可特（DFZ）/泼尼松（PDN）等效比为0.8，将其随机分为DFZ组（n = 20）或PDN组（n = 20）。治疗1年。接受DFZ治疗的患者复发次数显著更低。1年后，DFZ组有12例仍处于缓解期，而PDN组为2例。两组的生长速度无差异。通过L1、L2椎体定量计算机断层扫描评估的骨矿物质含量，1年后DFZ组下降6%，而PDN组下降12%（无显著性差异）。PDN组平均体重增加+3.9±4.1kg，高于DFZ组的+1.7±2.8kg（P = 0.06）。12个月后，DFZ组的库欣样症状倾向于更少。总之，本研究表明，在限制依赖类固醇的INS复发方面，DFZ比PDN更有效，并且与PDN相比，使用该药物时库欣样症状、体重增加和骨矿物质含量下降往往不那么明显。
