Corticosteroid treatment and growth patterns in ambulatory males with Duchenne Muscular Dystrophy | DuchenneXchange

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Scientific Articles

Corticosteroid treatment and growth patterns in ambulatory males with Duchenne Muscular Dystrophy

key information

source: The Journal of Pediatrics

year: 2016

authors: Molly M. Lamb, Nancy A. West, Lijing Ouyang, Michele Yang, David Weitzenkamp, Katherine James, Emma Ciafaloni, Shree Pandya, Carolyn DiGuiseppi

summary/abstract:

Objectives:
To evaluate growth patterns of ambulatory males with Duchenne muscular dystrophy (DMD) treated with corticosteroids compared with ambulatory, steroid-naïlve males with DMD and age-matched unaffected general-population males and to test associations between growth and steroid treatment patterns among treated males.

Study design:
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).

Results:
Growth curves for ambulatory males treated with corticosteroids showed significantly shorter stature, heavier weight, and greater BMI compared with ambulatory, steroid-naïlve 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.

Conclusion:
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.

organisation: Colorado School of Public Health, USA; University of Mississippi Medical Center, USA; Centers for Disease Control and Prevention, USA; Children's Hospital Colorado, USA; University of Rochester, USA

DOI: 10.1016/j.jpeds.2016.02.067

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