B. Andre et al., Methylprednisolone, an alternative to dexamethasone in very premature infants at risk of chronic lung disease, INTEN CAR M, 26(10), 2000, pp. 1496-1500
Objective:To evaluate the benefits and the medium-term side effects of meth
ylprednisolone in very preterm infants at risk of chronic lung disease.
Study design: Forty-five consecutive preterm infants (<30 weeks' gestation)
at risk of chronic lung disease were treated at a mean postnatal age of 16
days with a tapering course of methylprednisolone. The outcome of treatmen
t was assessed by comparison with 45 consecutive historical cases of infant
s treated with dexamethasone: the infants did not differ in baseline charac
teristics.
Results: There were no differences between groups in the rate of survivors
without chronic lung disease. Infants treated with methylprednisolone had a
higher rate of body weight gain during the treatment period (median 120 g,
range 0 to 190, vs. 70 g, range -110 to 210, P = 0.01) and between birth a
nd the age of 40 weeks (median 1660 g, range 1170-2520, vs. 1580 g, range 1
040 to 2120, P = 0.02). The incidence of both glucose intolerance requiring
insulin (0 % vs. 18 %, P = 0.006) and cystic periventricular leukomalacia
(2 % vs. 18 %, P = 0.03) was lower among methyl-prednisolone-treated infant
s.
Conclusion: Our observations confirm methylprednisolone to be as effective
as dexamethasone and to have fewer side effects. A randomized control trial
is needed to further study the efficacy and safety of methylprednisolone i
n very premature infants at risk of chronic lung disease.