Steroids help Duchenne muscular dystrophy patients walk better
Young boys with Duchenne muscular dystrophy (MD) can walk for as long as three additional years when they are administered with corticosteroids on a daily basis.
This finding was disclosed in a study that was supported by the General Clinical Research Center at the Ohio State University and the National Center of Research Resources of NIH.
From Medpagetoday.com:
The reason for non-treatment with steroids was invariably parent refusal because of fear of side effects, the researchers said. The average duration of steroid use was 8.04 years.
The study found:
* Boys on steroids were able to walk independently, on average, 3.3 years longer than those who weren’t treated. The difference — from 9.21 years to 12.52 years — was significant at P<0.0001.
* The prevalence of scoliosis in the treated boys was 31%, compared with 91% among those not getting steroids, a difference that was significant at P<0.0001.
* The average scoliotic curve was 11.6 degrees in the treated boys, compared with 33.2 degrees in the untreated boys, which was also significant at P<0.0001.
* On the other hand, 32% of the treated boys had vertebral compression fractures versus none in those not getting steroids, which was significant at P<0.0012.
* The yearly long-bone fracture rate was 0.088 among the treated boys, but only 0.033 in the untreated group, difference by a factor of 2.6, which was significant at P<0.0032.
Several factors probably play a role in the increased rate of long-bone fractures, the researchers said, including prolonged independent walking and increased body weight because of the steroids.
Wendy King, a physical therapist in the neurology department at Ohio State University, remarked that the risk of scoliosis and the magnitude of curvature are sharply reduced with daily administration of corticosteroids. It was suggested by the study that calcium supplements should be recommended to patients with Duchenne MD and regular bone mineral density exams are recommended at intervals of 6-24 months due to the orthopedic implications of steroids.
