Bolus administration of steroid therapy is more favorable than the conventional use in preventing decrease of bone density and the increase of body fat percentage in patients with inflammatory bowel disease

Klaudia Farkas, Anita Bálint, Zsuzsanna Valkusz, Zoltán Szepes, Ferenc Nagy, Mónika Szucs, Renáta Bor, Tibor Wittmann, Tamás Molnár

Research output: Article

2 Citations (Scopus)

Abstract

Introduction: The effects of short course of corticosteroids on the metabolic processes and bone formation has not been well studied. Our aim was to compare the efficacy, the side effects and the bone and lipid metabolisms in IBD patients using bolus or conventional tapering of methylprednisolone for 12. weeks. Patients and methods: Nineteen IBD patients received intravenous methylprednisolone of 1. mg/kg for 5. days tapered by 4. mg per week. Patients were prospectively randomized in two groups. In "conventional" group (I) steroids were given daily. In "pulse" group (II) weekly doses of steroids were given on special days of the week. The body mass index (BMI) was measured before and after the corticosteroid therapy. Blood samples were collected to assess glucose level, electrolytes, cholesterol and triglyceride levels, inflammatory parameters, cortisol, osteocalcin and crosslaps values. Total body composition analysis was performed at the beginning and at the end of the steroid therapy. Results: In Group I, BMI increased, total body bone density decreased significantly at the end of the steroid therapy. Body fat percent showed a tendency to be higher at the end of steroid therapy in Group I. Cholesterol level increased significantly in Group I patients. The decrease in serum cortisol level was more remarkable in Group I vs. Group II after steroid therapy. Less side-effect occurred in Group II vs. Group I. Discussion: Our results suggest that bolus tapering of corticosteroids may have more favorable short term outcome than conventional tapering that may revolutionize steroid therapy in IBD.

Original languageEnglish
Pages (from-to)992-997
Number of pages6
JournalJournal of Crohn's and Colitis
Volume8
Issue number9
DOIs
Publication statusPublished - szept. 1 2014

ASJC Scopus subject areas

  • Gastroenterology

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