RETROSPECTIVE ANALYSIS OF ALTERNATE-DAY PREDNISONE MAINTENANCE THERAPY FOR CROHNS-DISEASE

We reviewed the medical records of 98 children with Crohn's disease fo llowed at Children's Hospital of Pittsburgh from 1983 to 1993 to evalu ate the merits of alternate-day prednisone (AD) maintenance therapy on ce initial remission was achieved. Of the 98 children, 35 had adequate data recorded for eligibility to the study. Of these, 11 were in the AD group and 24 were in a group whose maintenance regimen did not incl ude prednisone (NO). The dependent variables were frequency of flares and linear growth over time. AD therapy reduced mean symptomatic flare s (0.23 +/- 0.1 vs 0.69 +/- 0.14 flares/patient/year; p=0.04) over a 2 -year follow-up period but did not delay significantly the onset of a flare after remission was achieved (16.5 +/- 3.4, vs 13.4 +/- 1.8 mont hs; p=0.4), Site of disease involvement had no impact on frequency of flares. Fewer patients in the AD group experienced flares, but this fi nding did not achieve statistical significance (4/11, 36%, vs 17/24, 7 1%; p=0.07). Linear growth, measured in height percentile and growth v elocity (cm/year), was not significantly reduced by the second year of either therapy. This small retrospective study suggests that AD predn isone therapy may be effective in reducing symptomatic flares in Crohn 's patients without a resultant inhibition of linear growth.