OBJECTIVE: To establish whether the oral administration of moderate doses of prednisone reduces refractory vertigo in Ménière's disease. STUDY DESIGN: Blinded, randomized, controlled trial. SETTING: Tertiary referral center. PATIENTS: Patients with Ménière's disease with limited vertigo control (Class C) and severe disability (Scale 3). INTERVENTIONS: Two groups (n = 8 per group) were treated orally with either diphenidol (25 mg/d) plus acetazolamide (250 mg/48 h) (control group), or the same treatment plus prednisone (0.35 mg/kg) daily for 18 weeks (prednisone group). MAIN OUTCOME MEASURES: The variables evaluated were the frequency and duration of vertigo, tinnitus, aural fullness, and audiographic parameters. The clinical surveillance was performed for 12 months after prednisone withdrawal. RESULTS: The frequency and duration of vertigo episodes were reduced by 50% and 30%, respectively, by prednisone treatment. Prednisone-treated patients manifested a significant reduction in tinnitus. No changes were observed in aural fullness or hearing. No metabolic or infectious disorders were observed. CONCLUSION:Oral prednisone helps to control refractory vertigo in Ménière's disease. These preliminary data suggest that prednisone can be a good noninvasive antivertigo management regimen for these patients.
RCT Entities:
OBJECTIVE: To establish whether the oral administration of moderate doses of prednisone reduces refractory vertigo in Ménière's disease. STUDY DESIGN: Blinded, randomized, controlled trial. SETTING: Tertiary referral center. PATIENTS: Patients with Ménière's disease with limited vertigo control (Class C) and severe disability (Scale 3). INTERVENTIONS: Two groups (n = 8 per group) were treated orally with either diphenidol (25 mg/d) plus acetazolamide (250 mg/48 h) (control group), or the same treatment plus prednisone (0.35 mg/kg) daily for 18 weeks (prednisone group). MAIN OUTCOME MEASURES: The variables evaluated were the frequency and duration of vertigo, tinnitus, aural fullness, and audiographic parameters. The clinical surveillance was performed for 12 months after prednisone withdrawal. RESULTS: The frequency and duration of vertigo episodes were reduced by 50% and 30%, respectively, by prednisone treatment. Prednisone-treated patients manifested a significant reduction in tinnitus. No changes were observed in aural fullness or hearing. No metabolic or infectious disorders were observed. CONCLUSION: Oral prednisone helps to control refractory vertigo in Ménière's disease. These preliminary data suggest that prednisone can be a good noninvasive antivertigo management regimen for these patients.