6-METHYLPREDNISOLONE MINI-PULSES - A NEW MODALITY OF GLUCOCORTICOID TREATMENT IN SYSTEMIC-ONSET JUVENILE CHRONIC ARTHRITIS

From 1989 to 1994 we have been following in our Department 22 patients (12 males, 10 females, age range 1-13.5 years) affected by sJCA who u nderwent glucocorticoid (GC) treatment. These patients were randomised to receive for 6 months two different GC schedules: group A (12) rece ived 6 methylprednisolone (6MP) i.v. for 3 days with 5 mg/kg/d and for an additional 3 days at 2.5 mg/kg/d followed by po prednisone (1 mg/k g/d); group B (10) received po prednisone (1 mg/kg/d). A remarkable de crease of disease activity and fever score and a prompt improvement of joint involvement were observed. A CPR serum concentration decrease a ssociated to a consistent increase of Hb over baseline values were dis closed in group A. GC cumulative daily requirement was significantly l ower in group A. Four patients from group B but only one from group A developed a cushingoid appearance: no differences of BMI were found in the two groups. Our study shows that in sJCA patients i.v. GC mini pu lses are effective on early clinical and biological parameters of infl ammation and requires a lower cumulative daily dosage than conventiona l oral GC treatment.