Effect of prednisolone on language function in children with autistic spectrum disorder: a randomized clinical trial

Brito, Alexandre dos Santos; Vairo, Giselle de Paula Teixeira; Dias, Ana Paula Botelho Henriques; Olej, Beni; Nascimento, Osvaldo J. M.; Vasconcelos, Marcio Moacyr

doi:10.1016/j.jped.2019.10.012

Cited by 9 publications

(19 citation statements)

References 27 publications

(29 reference statements)

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“… Intranasal vasopressin (AVP) 46 30 United States SRS, CGI-I, Reading the Mind in the Eyes Test (RMET) and Facial Emotion Recognition Test (FERT) Individuals with ASD, treated with intranasal AVP for 4 weeks showed greater improvement when compared to placebo in their social abilities as assessed by 4 different outcome measures; the SRS-2 score (p = 0.0052), the CGI-I scale (p = 0.0145), the RMET (p = 0.047); and the FERT (p = 0.0132). Prednisolone 47 38 Brazil Language Development Assessment (ADL) and the Child Language Test in Phonology, Vocabulary, Fluency, and Pragmatics (ABFW). Prednisolone increased the global ADL score in children younger than 5 years of age who had developmental regression (p = 0.0057).…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…A study involving the use of prednisolone displayed promising effectiveness against social communication deficits and this was the first prospective study in medical literature based on a double-blinded, randomized, placebo-controlled clinical trial on the treatment of ASD with corticosteroids. 47 Two pharmacological agents, atomoxetine and guanfacine which are both indicated for use in ADHD, resulted in positive outcomes on the core symptoms and comorbidities of ASD. Guanfacine in some studies resulted in improvements in hyperactivity, 17 oppositional behavior, 30 and core symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…The prednisolone dose of 1 mg/kg/day used during the first eight weeks of the trial was low therefore the study concluded that a higher dose would have achieved more favorable intervention outcomes. 47 Additionally, studies that utilize non-pharmacological agents; methyl B12 48 and vitamin D and omega-3 long-chain polyunsaturated fatty acids 49 also displayed effectiveness for social communication and social interaction challenges as indicated numerically in Table 2.…”

Section: Dovepressmentioning

confidence: 99%

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Pharmacological Management of Core Symptoms and Comorbidities of Autism Spectrum Disorder in Children and Adolescents: A Systematic Review

Maniram¹,

Karrim²,

Oosthuizen³

et al. 2022

NDT

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Purpose The pharmacological management of Autism Spectrum Disorder (ASD) in children remains a challenge due to limited effective management options and the absence of approved drugs to manage the core symptoms. This review aims to describe and highlight effective pharmacological management options employed in managing the core symptoms and comorbidities of ASD from eligible studies over the past decade. Methods A search of databases; PubMed, Scopus, Science Direct, and PsychInfo for pharmacotherapeutic options for ASD was conducted in this systematic review. Duplicate studies were removed by utilizing the EndNote citation manager. The studies were subsequently screened independently by two authors. Eligible studies from 01 January 2012 to 01 January 2022 were included based on established eligibility criteria. A narrative synthesis was used for data analysis. Results The systematic review provides a comprehensive list of effective management options for ASD comorbidities and core symptoms from 33 included studies. The management options for ASD comorbidities; insomnia, hyperactivity, irritability and aggression, gastrointestinal disturbances, and subclinical epileptiform discharges, were reviewed. Risperidone, aripiprazole, methylphenidate, guanfacine, levetiracetam, and atomoxetine are examples of effective pharmacological drugs against ASD comorbidities. Additionally, this review identified various drugs that improve the core symptoms of ASD and include but are not limited to, bumetanide, buspirone, intranasal oxytocin, intranasal vasopressin, and prednisolone. Conclusion This review has successfully summarized the pharmacological advancements made in the past decade to manage ASD. Although there is still no pharmacological cure for ASD core symptoms or additional drugs that have obtained regulatory approval for use in ASD, the availability of promising pharmacological agents are under evaluation and study.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Dovepressmentioning

confidence: 99%

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Pharmacological Management of Core Symptoms and Comorbidities of Autism Spectrum Disorder in Children and Adolescents: A Systematic Review

Maniram¹,

Karrim²,

Oosthuizen³

et al. 2022

NDT

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“…The related use of immune modulating agents in ASD is also gaining recognition (41,42). Primary immunomodulatory agents such as intravenous immunoglobulin (IVIG) (43), corticosteroids (44,45), adrenocorticotropic hormone (ACTH) (46) and celecoxib (47) as possible treatments for core autism symptoms have garnered research attention, alongside recognition that other medications widely used in ASD, such as the atypical antipsychotic risperidone for example, have immunomodulatory actions (48).…”

Section: Introductionmentioning

confidence: 99%

Autoimmune Encephalitis and Autism Spectrum Disorder

Whiteley¹,

Marlow

Kapoor

et al. 2021

Front. Psychiatry

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The concept of “acquired autism” refers to the hypothesis that amongst the massive heterogeneity that encompasses autism spectrum disorder (ASD) there may be several phenotypes that are neither syndromic nor innate. Strong and consistent evidence has linked exposure to various pharmacological and infective agents with an elevated risk of a diagnosis of ASD including maternal valproate use, rubella and herpes encephalitis. Autoimmune encephalitis (AE) describes a group of conditions characterised by the body's immune system mounting an attack on healthy brain cells causing brain inflammation. The resultant cognitive, psychiatric and neurological symptoms that follow AE have also included ASD or autism-like traits and states. We review the current literature on AE and ASD. Drawing also on associated literature on autoimmune psychosis (AP) and preliminary evidence of a psychosis-linked subtype of ASD, we conclude that AE may either act as a potentially causative agent for ASD, and/or produce symptoms that could easily be mistaken for or misdiagnosed as autism. Further studies are required to discern the connection between AE and autism. Where autism is accompanied by regression and atypical onset patterns, it may be prudent to investigate whether a differential diagnosis of AE would be more appropriate.

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Immunoregulatory and/or Anti-inflammatory Agents for the Management of Core and Associated Symptoms in Individuals with Autism Spectrum Disorder: A Narrative Review of Randomized, Placebo-Controlled Trials

2023

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Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental condition with a so far poorly understood underlying pathogenesis, and few effective therapies for core symptoms. Accumulating evidence supports an association between ASD and immune/inflammatory processes, arising as a possible pathway for new drug intervention. However, current literature on the efficacy of immunoregulatory/anti-inflammatory interventions on ASD symptoms is still limited. The aim of this narrative review was to summarize and discuss the latest evidence on the use of immunoregulatory and/or anti-inflammatory agents for the management of this condition. During the last 10 years, several randomized, placebo-controlled trials on the effectiveness of (add-on) treatment with prednisolone, pregnenolone, celecoxib, minocycline, N -acetylcysteine (NAC), sulforaphane (SFN), and/or omega-3 fatty acids have been performed. Overall, a beneficial effect of prednisolone, pregnenolone, celecoxib, and/or omega-3 fatty acids on several core symptoms, such as stereotyped behavior , was found. (Add-on) treatment with prednisolone, pregnenolone, celecoxib, minocycline, NAC, SFN, and/or omega-3 fatty acids was also associated with a significantly higher improvement in other symptoms, such as irritability , hyperactivity , and/or lethargy when compared with placebo. The mechanisms by which these agents exert their action and improve symptoms of ASD are not fully understood. Interestingly, studies have suggested that all these agents may suppress microglial/monocyte proinflammatory activation and also restore several immune cell imbalances (e.g., T regulatory/T helper-17 cell imbalances), decreasing the levels of proinflammatory cytokines, such as interleukin (IL)-6 and/or IL-17A, both in the blood and in the brain of individuals with ASD. Although encouraging, the performance of larger randomized placebo-controlled trials, including more homogeneous populations, dosages, and longer periods of follow-up, are urgently needed in order to confirm the findings and to provide stronger evidence.

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Effect of prednisolone on language function in children with autistic spectrum disorder: a randomized clinical trial

Cited by 9 publications

References 27 publications

Pharmacological Management of Core Symptoms and Comorbidities of Autism Spectrum Disorder in Children and Adolescents: A Systematic Review

Pharmacological Management of Core Symptoms and Comorbidities of Autism Spectrum Disorder in Children and Adolescents: A Systematic Review

Autoimmune Encephalitis and Autism Spectrum Disorder

Immunoregulatory and/or Anti-inflammatory Agents for the Management of Core and Associated Symptoms in Individuals with Autism Spectrum Disorder: A Narrative Review of Randomized, Placebo-Controlled Trials

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