The effects of single‐dose alternate‐day prednisone therapy on the immunological status of patients with neuromuscular diseases

Abstract

Several immunological variables were examined in patients receiving high-single-dose, alternate-day prednisone therapy for neuromuscular diseases. Dose-dependent leukocytosis, lymphopenia, and monocytopenia occurred which were maximal 6 hours after prednisone administration but returned to control levels by the 24-hour point. The lymphopenia involved T-cells, B-cells, and null cells, with the T-cells most affected. Plasma cortisol levels and lymphocyte transformation in response to mitogens were also transiently and reversibly suppressed. There was a persistent decrease in serum IgG. Lymphocyte transformation was also suppressed when normal lymphocytes were incubated with treated patient sera or when treated patient lymphocytes were incubated in autologous pretreatment sera. The suppression factor was not removed from the lymphocytes by extensive washing. Patients whose disease responded to the high-single-dose, alternate-day prednisone regiment were indistinguishable from nonresponders by the immunological responses measured.

Long-Term Outcome of Polymyositis Treated with High Single-Dose Alternate-Day Prednisolone Therapy

“…Since ADT was first introduced to treat immune disorders, it has also been used in patients with various immunogenic neuromuscular disorders [14,15,16,17]. During themore than 20 years since we began using ADT therapy, the number of PM/DM patients treated with ADT or DDT increased more than three times.…”