Journal article
Corticosteroid Treatment and Growth Patterns in Ambulatory Males with Duchenne Muscular Dystrophy
The Journal of pediatrics, Vol.173, pp.207-213.e3
06/2016
DOI: 10.1016/j.jpeds.2016.02.067
PMCID: PMC5100357
PMID: 27039228
Abstract
To evaluate growth patterns of ambulatory males with Duchenne muscular dystrophy (DMD) treated with corticosteroids compared with ambulatory, steroid-naïve males with DMD and age-matched unaffected general-population males and to test associations between growth and steroid treatment patterns among treated males.
Using data from the Muscular Dystrophy Surveillance, Tracking, and Research Network, we identified a total of 1768 height, 2246 weight, and 1755 body mass index (BMI) measurements between age 2 and 12 years for 324 ambulatory males who were treated with corticosteroids for at least 6 months. Growth curve comparisons and linear mixed-effects modeling, adjusted for race/ethnicity and birth year, were used to evaluate growth and steroid treatment patterns (age at initiation, dosing interval, duration, cumulative dose).
Growth curves for ambulatory males treated with corticosteroids showed significantly shorter stature, heavier weight, and greater BMI compared with ambulatory, steroid-naïve males with DMD and general-population US males. Adjusted linear mixed-effects models for ambulatory males treated with corticosteroids showed that earlier initiation, daily dosing, longer duration, and greater dosages predicted shorter stature with prednisone. Longer duration and greater dosages predicted shorter stature for deflazacort. Daily prednisone dosing predicted lighter weight, but longer duration, and greater dosages predicted heavier weight. Early initiation, less than daily dosing, longer duration, and greater doses predicted greater BMIs. Deflazacort predicted shorter stature, but lighter weight, compared with prednisone.
Prolonged steroid use is significantly associated with short stature and heavier weight. Growth alterations associated with steroid treatment should be considered when making treatment decisions for males with DMD.
Details
- Title: Subtitle
- Corticosteroid Treatment and Growth Patterns in Ambulatory Males with Duchenne Muscular Dystrophy
- Creators
- Molly M Lamb - Colorado School of Public Health, Aurora, CONancy A West - Colorado School of Public Health, Aurora, COLijing Ouyang - Centers for Disease Control and Prevention, Atlanta, GAMichele Yang - Children's Hospital Colorado, Aurora, CODavid Weitzenkamp - Children's Hospital Colorado, Aurora, COKatherine James - Colorado School of Public Health, Aurora, COEmma Ciafaloni - University of Rochester, Rochester, NYShree Pandya - University of Rochester, Rochester, NYCarolyn DiGuiseppi - Colorado School of Public Health, Aurora, COMuscular Dystrophy Surveillance, Research, and Tracking Network (MD STARnet) (Author)
- Contributors
- Paul A Romitti (Contributor) - University of Iowa, EpidemiologyKatherine D Mathews (Contributor) - University of Iowa, Stead Family Department of PediatricsSoman Puzhankara (Contributor) - University of Iowa, Epidemiology
- Resource Type
- Journal article
- Publication Details
- The Journal of pediatrics, Vol.173, pp.207-213.e3
- DOI
- 10.1016/j.jpeds.2016.02.067
- PMID
- 27039228
- PMCID
- PMC5100357
- NLM abbreviation
- J Pediatr
- ISSN
- 0022-3476
- eISSN
- 1097-6833
- Publisher
- Elsevier Inc
- Grant note
- DD000187; DD000189; DD000190; DD000191 / Centers for Disease Control and Prevention (http://dx.doi.org/10.13039/100000030)
- Language
- English
- Date published
- 06/2016
- Academic Unit
- Neurology; Stead Family Department of Pediatrics; Epidemiology; Iowa Neuroscience Institute; Biostatistics; Neurology (Pediatrics)
- Record Identifier
- 9983995126002771
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