Pharmacokinetics of intravenous methylprednisolone and oral prednisone in paediatric patients with inflammatory bowel disease during the acute phase and in remission

Fauré, Christophe; André, J; Pélatan, C.; Munck, À.; Giraud, Marie-Noëlle; Cézard, J.P.; Jacqz-Aigrain, Évelyne

doi:10.1007/s002280050512

Cited by 20 publications

(8 citation statements)

References 21 publications

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“…In our animal study, hyperglycemia was not observed. When MP is given in a small dose, the half-life varies from 3.8 to 7.2 h, which was sufficient in duration for our experiment to have the optimal effects from the drug (20). Clinically, arterial oxygenation during OLV remains an important parameter for the following reasons.…”

Section: Discussionmentioning

confidence: 99%

Low dose methylprednisolone prophylaxis to reduce inflammation during one‐lung ventilation

Theroux¹,

Olivant²,

Lim³

et al. 2008

Pediatric Anesthesia

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Background:The specific aim of this study was to examine the efficacy of a low dose of methylprednisolone in minimizing inflammatory response in juvenile piglets when given 45-60 min prior to onset of one-lung ventilation. Methods: Twenty piglets aged 3 weeks were assigned to either the control group (n = 10) or methylprednisolone group (n = 10). The animals were anesthetized and after 30 min of ventilation, they had their left lung blocked. Ventilation was continued via right lung for 3 h. The left lung was then unblocked. Following another 30 min of bilateral ventilation, the animals were euthanized and both lungs were harvested. The methylprednisolone group had a single dose (2 mgAEkg )1 ) of methylprednisolone given i.v. 45-60 min prior to onset of one-lung ventilation. Physiological parameters (PaO 2 , resistance, and compliance) and markers of inflammation (tumor necrosis factor [TNF]-a, interleukin [IL]-1b, IL-6, and IL-8) were measured at baseline and every 30 min thereafter. Lung tissue homogenates from both collapsed and ventilated lungs were analyzed for TNF-a, IL-1b, IL-6, and IL-8. Results: The methylprednisolone group had higher partial pressure of oxygen (P = 0.01), lower plasma levels of TNF-a (P = 0.03) and IL-6 (P = 0.001) when compared with control group. Lung tissue homogenate in the methylprednisolone group had lower levels of TNF-a (P < 0.05), IL-1b (P < 0.05), and IL-8 (P < 0.05) in both the collapsed and the ventilated lungs. Conclusions: In a piglet model of one-lung ventilation, use of prophylactic methylprednisolone prior to collapse of the lung improves lung function and decreases systemic pro-inflammatory response. In addition, in the piglets who received methylprednisolone, there were reduced levels of inflammatory mediators in both the collapsed and ventilated lungs.

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Section: Discussionmentioning

confidence: 99%

Low dose methylprednisolone prophylaxis to reduce inflammation during one‐lung ventilation

Theroux¹,

Olivant²,

Lim³

et al. 2008

Pediatric Anesthesia

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“…Methylprednisolone pharmacokinetics is characterized by a very short half-life (about 2 hours) and although steroid binding to plasma protein is about 75%, the volume of distribution is very large (about 1.5 L/kg) [29]. These factors are the key of the negligible PLEX effect upon steroids biodisponibility [30, 31].…”

Section: Plasma Exchange Proceduresmentioning

confidence: 99%

Plasma Exchange in Severe Attacks of Neuromyelitis Optica

Bonnan¹,

Cabre

2012

Multiple Sclerosis International

115

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Background. Neuromyelitis optica (NMO) attacks are poorly controlled by steroids and evolve in stepwise neurological impairments. Assuming the strong humoral response underlying NMO attacks, plasma exchange (PLEX) is an appropriate technique in severe NMO attacks. Objective. Presenting an up-to-date review of the literature of PLEX in NMO. Methods. We summarize the rationale of PLEX in relation with the physiology of NMO, the main technical aspects, and the available studies. Results. PLEX in severe attacks from myelitis or optic neuritis are associated with a better outcome, depending on PLEX delay (“time is cord and eyes”). NMO-IgG status has no influence. Finally, we build up an original concept linking the inner dynamic of the lesion, the timing of PLEX onset and the expected clinical results. Conclusion. PLEX is a safe and efficient add-on therapy in NMO, in synergy with steroids. Large therapeutic trials are required to definitely assess the procedure and define the time opportunity window.

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“…We used MP at a concentration of 10 À6 M. This concentration is approximately equal to the plasma concentration of MP 1 h after the end of a 2-h intravenous administration of 2 mg/kg MP (Faure et al, 1998).…”

Section: Discussionmentioning

confidence: 99%

Effects of intravenous immunoglobulin and methylprednisolone on human umbilical vein endothelial cells in vitro

et al. 2006

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Pharmacokinetics of intravenous methylprednisolone and oral prednisone in paediatric patients with inflammatory bowel disease during the acute phase and in remission

Abstract: In children with inflammatory bowel disease, the initial response to corticosteroid therapy was not influenced by the pharmacokinetics of prednisolone and methylprednisolone. In addition, the pharmacokinetics of prednisolone was not modified by the inflammatory syndrome.

Cited by 20 publications

References 21 publications

Low dose methylprednisolone prophylaxis to reduce inflammation during one‐lung ventilation

Low dose methylprednisolone prophylaxis to reduce inflammation during one‐lung ventilation

Plasma Exchange in Severe Attacks of Neuromyelitis Optica

Effects of intravenous immunoglobulin and methylprednisolone on human umbilical vein endothelial cells in vitro

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