Clinical and Endocrine Side-effects of Methylprednisolone Acetate as used in Hay-fever

Abstract

Summary: Eight patients were treated with two 80-mg.doses of methylprednisolone acetate (Depo-Medrone), given at an interval of two weeks. Pituitary-adrenal function was assessed before, during, and after treatment.Plasma cortisol levels were depressed maximally 72 hours after each injection of methylprednisolone acetate, and then gradually returned to normal. The adrenocortical response to administered corticotrophin was similarly affected; in seven patients normal values were again recorded three weeks after the second injection of methylprednisolone acetate. One patient whose adrenal function had returned to normal still showed some degree of pituitary suppression eight weeks after his second injection. Several side-effects were noted, and clinically the patients fared less well than a larger series studied during the previous year. IntroductionMethylprednisolone acetate (Depo-Medrone), a slow-release steroid for injection, is used in the treatment of allergic and other disorders but no information is available to indicate the effect of this treatment on the hypothalamicpituitary-adrenal axis. It seemed desirable, therefore, to assess hypothalamic-pituitary-adrenal function in a group of patients receiving methylprednisolone acetate in the dosage used for a recent trial of hay-fever treatment (Ganderton, Brostoff, and Frankland, 1969), when two 80-mg. injections of methylprednisolone acetate were given at an interval of two weeks. The effect on the resting plasma cortisol level, on the response of the adrenal gland to synthetic adrenocorticotrophic hormone (Synacthen), and on the plasma cortisol response to the stress of insulin-induced hypoglycaemia was studied.

Short‐term growth in children with allergic rhinitis treated with oral antihistamine, depot and intranasal glucocorticosteroids

“…Furthermore, the individual lower leg growth curves indicated that the short-term growth suppressive effect of methylprednisolone acetate treatment was only transient. This is in accordance with previous reports of a transient suppressive effect of depot steroids on the adrenocortical secretion of cortisol in adults (4,5). Thus our data suggest that a single injection of methylprednisolone acetate may not be associated with any effect on long-term growth.…”

“…Topical and systemic glucocorticosteroids have been found to be superior to oral antihistamines in controlling the symptoms (1)(2)(3). Systemic glucocorticosteyoids are often given as a single injection of a long-acting depot steroid at the beginning of the pollen season (4)(5)(6). However, such treatment may be associated with a risk of serious side effects, such as suppression of longitudinal growth (2,6,7).…”

Seasonal allergic rhinitis and depot injection of a corticosteroid

“…It showed that the effect of 80 mg methylprednisolone on nasal blockage was marked and lasted for more than 4 weeks. That this beneficial effect outlasted the pharmacological action ofthe drug, estimated by the effect on the hypothalamic-pituitary-adrenal axis to be about 2 weeks (8,9), suggests that an impact steroid therapy in rhinitis can break some viscious circles, probably caused by chronic inflammation and the development of mucosal hyperreactivity ("priming effect") (5).…”

Drug treatment for nasal allergy

“…Depot injections of the microcrystailine ester methylprednisolone-acetate (DepoMedrone®), equivalent to 100 mg of prednisolone, are used widely for the control of hay fever. Such injections probably suppress adrenal function for up to 3 weeks and in a few cases cause atrophy at the site of injection [59]. However, they are effective, particularly in the control of nasal obstruction [60].…”