BACKGROUND: Pharmacokinetic half-life of prednisolone is 2-3 h, indicating short pharmacodynamic effect duration. Therefore, the fractionated twice daily administration of prednisolone might be favorable. PATIENTS AND METHODS: A 6-month observational study was conducted in a total of 51 patients, 35 with glomerulonephritis and 16 with kidney transplants. Low-dose and long-term prednisolone was given twice daily to 37 patients and once daily to 14 patients. RESULTS: The median dose (first-third quartile) for fractionated prednisolone was 2 x 1.25 mg/day (2.5-2.6) and significantly lower (p = 0.008) than the once daily standard dose of 1 x 4.0 mg/day (2.5-5.0). The number of comedications was also significantly lower in the fractionated dose group: 1.0 co-immunosuppressant (0.0-1.0) compared to 1.5 drugs (0.25-2.0) such as cyclosporine and/or mycophenolate (p = 0.017), and 0.0 antidiabetics (0.0-0.0) versus 0.0 drugs (0.0-0.75) such as gliquidone (p = 0.032). The fall in proteinuria was significant in the fractionated dose group with -0.12 g/l (-0.4-0.0) versus +0.08 g/l (-0.04-+0.24) in controls (p = 0.008). CONCLUSION: Twice daily fractionated administration of prednisolone allows a lower daily dose (total 2.5 mg/day), and appears to be as efficient but less diabetogenic compared to the standard once daily dosing (4.0 mg/day).
BACKGROUND: Pharmacokinetic half-life of prednisolone is 2-3 h, indicating short pharmacodynamic effect duration. Therefore, the fractionated twice daily administration of prednisolone might be favorable. PATIENTS AND METHODS: A 6-month observational study was conducted in a total of 51 patients, 35 with glomerulonephritis and 16 with kidney transplants. Low-dose and long-term prednisolone was given twice daily to 37 patients and once daily to 14 patients. RESULTS: The median dose (first-third quartile) for fractionated prednisolone was 2 x 1.25 mg/day (2.5-2.6) and significantly lower (p = 0.008) than the once daily standard dose of 1 x 4.0 mg/day (2.5-5.0). The number of comedications was also significantly lower in the fractionated dose group: 1.0 co-immunosuppressant (0.0-1.0) compared to 1.5 drugs (0.25-2.0) such as cyclosporine and/or mycophenolate (p = 0.017), and 0.0 antidiabetics (0.0-0.0) versus 0.0 drugs (0.0-0.75) such as gliquidone (p = 0.032). The fall in proteinuria was significant in the fractionated dose group with -0.12 g/l (-0.4-0.0) versus +0.08 g/l (-0.04-+0.24) in controls (p = 0.008). CONCLUSION: Twice daily fractionated administration of prednisolone allows a lower daily dose (total 2.5 mg/day), and appears to be as efficient but less diabetogenic compared to the standard once daily dosing (4.0 mg/day).
Authors: F Obata; K Yoshida; M Ohkubo; Y Ikeda; Y Taoka; Y Takeuchi; N Shinohara; T Endo; S Baba Journal: Transpl Immunol Date: 2004-12-08 Impact factor: 1.708
Authors: A Ekstrand; C Schalin-Jäntti; M Löfman; M Parkkonen; E Widén; A Franssila-Kallunki; C Saloranta; V Koivisto; L Groop Journal: Transplantation Date: 1996-03-27 Impact factor: 4.939
Authors: B Oosterhuis; R J ten Berge; H P Sauerwein; E Endert; P T Schellekens; C J van Boxtel Journal: J Pharmacol Exp Ther Date: 1984-05 Impact factor: 4.030
Authors: Angelique L W M M Rops; Johan van der Vlag; Joost F M Lensen; Tessa J M Wijnhoven; Lambert P W J van den Heuvel; Toin H van Kuppevelt; Jo H M Berden Journal: Kidney Int Date: 2004-03 Impact factor: 10.612