PT  - JOURNAL ARTICLE
AU  - Gloss, David
AU  - Moxley, Richard T.
AU  - Ashwal, Stephen
AU  - Oskoui, Maryam
TI  - Practice guideline update summary: Corticosteroid treatment of Duchenne muscular dystrophy
AID  - 10.1212/WNL.0000000000002337
DP  - 2016 Feb 02
TA  - Neurology
PG  - 465--472
VI  - 86
IP  - 5
4099  - http://n.neurology.org/content/86/5/465.short
4100  - http://n.neurology.org/content/86/5/465.full
SO  - Neurology2016 Feb 02; 86
AB  - Objective: To update the 2005 American Academy of Neurology (AAN) guideline on corticosteroid treatment of Duchenne muscular dystrophy (DMD).Methods: We systematically reviewed the literature from January 2004 to July 2014 using the AAN classification scheme for therapeutic articles and predicated recommendations on the strength of the evidence.Results: Thirty-four studies met inclusion criteria.Recommendations: In children with DMD, prednisone should be offered for improving strength (Level B) and pulmonary function (Level B). Prednisone may be offered for improving timed motor function (Level C), reducing the need for scoliosis surgery (Level C), and delaying cardiomyopathy onset by 18 years of age (Level C). Deflazacort may be offered for improving strength and timed motor function and delaying age at loss of ambulation by 1.4–2.5 years (Level C). Deflazacort may be offered for improving pulmonary function, reducing the need for scoliosis surgery, delaying cardiomyopathy onset, and increasing survival at 5–15 years of follow-up (Level C for each). Deflazacort and prednisone may be equivalent in improving motor function (Level C). Prednisone may be associated with greater weight gain in the first years of treatment than deflazacort (Level C). Deflazacort may be associated with a greater risk of cataracts than prednisone (Level C). The preferred dosing regimen of prednisone is 0.75 mg/kg/d (Level B). Over 12 months, prednisone 10 mg/kg/weekend is equally effective (Level B), with no long-term data available. Prednisone 0.75 mg/kg/d is associated with significant risk of weight gain, hirsutism, and cushingoid appearance (Level B).AAN=American Academy of Neurology; AE=adverse event; CI=confidence interval; DMD=Duchenne muscular dystrophy; FVC=forced vital capacity; LVEF=left ventricular ejection fraction; MEP=maximal expiratory pressure; QMT=quantitative muscle testing; QoL=quality of life; RR=relative rate; SF=shortening fraction