Prednisone and Methylprednisolone Disposition in the Lung

Braude, A.C.; Rebuck, A. S.

doi:10.1016/s0140-6736(83)90981-9

Cited by 55 publications

(20 citation statements)

References 11 publications

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“…Thus, a better reduction is seen in the overall respiratory system in ammation compared to dexamethasone. This is in the same line with other studies that demonstrated better penetrance of methylprednisolone in the lung tissue than other corticosteroids (41)(42)(43).…”

Section: Discussionsupporting

confidence: 92%

“…In this study, we aimed to evaluate the therapeutic effect of methylprednisolone as an add-on treatment to the standard treatment regimen of hospitalized COVID-19 patients. Our data were compared with a previously accepted corticosteroid treatment, dexamethasone, based on the hypothesis that methylprednisolone has higher lung penetration (29,30); therefore, it can act as a better immunosuppressive agent in the treatment of COVID-19 and improvement of respiratory complications. Following this theory, our data showed a signi cant bene cial effect of methylprednisolone in the patients' treatment course and outcome, in terms of clinical status score (based on ordinal scale score), hospitalization duration, and need for mechanical ventilation.…”

Section: Discussionmentioning

confidence: 99%

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Methylprednisolone or Dexamethasone, Which One Is the Superior Corticosteroid in the Treatment of Hospitalized COVID-19 Patients: A Triple-Blinded Randomized Controlled Trial

Ranjbar

Shahriarirad

Erfani

et al. 2021

Preprint

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BackgroundAlthough almost a year has passed since the Coronavirus disease 2019 (COVID-19) outbreak and promising reports of vaccines have been presented, we still have a long way until these measures are available for all. Furthermore, unsolved issues remained to choose appropriate corticosteroids treatment for COVID-19. We conducted a study to assess the effectiveness of methylprednisolone treatment versus dexamethasone for hospitalized COVID-19 patients.MethodIn this prospective triple-blinded randomized controlled trial, we enrolled 86 hospitalized COVID-19 patients from August to November 2020, in Shiraz, Iran. Patients were randomly allocated into two groups to receive either methylprednisolone (2mg/kg/day) or dexamethasone (6mg/kg/day). Data was assessed based on a 9-point WHO ordinal scale extending from uninfected (point 0) to death (point 8).ResultsThere was no significant variation among the groups on the admission. However, the intervention group demonstrated significantly better clinical status compared to the control group at day 5 (4.02 vs. 5.21, P = 0.002) and day 10 (2.90 vs. 4.71, P = 0.001) of admission. There was also a significant difference in the overall mean score between the intervention group, and the control group, (3.909 vs. 4.873 respectively, P = 0.004). The mean length of hospital stay was 7.43 ± 3.64 and 10.52 ± 5.47 days in the intervention and control groups, respectively (P = 0.015). The need for a ventilator was significantly lower in the intervention group than in the control group (18.2% vs 38.1% P = 0.040).ConclusionIn the context of treating hospitalized hypoxic COVID-19 patients, methylprednisolone demonstrated better results compared to dexamethasone.Trial Registration:The trial was registered with IRCT.IR (08/04/2020-No. IRCT20200204046369N1).

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Methylprednisolone or Dexamethasone, Which One Is the Superior Corticosteroid in the Treatment of Hospitalized COVID-19 Patients: A Triple-Blinded Randomized Controlled Trial

Ranjbar

Shahriarirad

Erfani

et al. 2021

Preprint

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“…We previously reported that more than 26% of chronic renal failure patients showed prednisolone resistance, whereas none of the 93 patients examined showed methylprednisolone resistance in a mitogen assay procedure using peripheral‐blood lymphocytes [2]. The molecular basis for the unexpectedly strong immunosuppressive potency of methylprednisolone when compared with prednisolone is unclear, but some previous reports demonstrated a difference in the amount of glucocorticoid penetrated into the target organ [12–14]. Such differences in the tissue or cell disposition of glucocorticoids may affect the cellular pharmacodynamics of the drug.…”

Section: Discussionmentioning

confidence: 99%

A comparison of prednisolone and methylprednisolone for renal transplantation

Hirano

Oka

Takeuchi

et al. 2000

Clinical Transplantation

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A large difference in immunosuppressive potency between methylprednisolone and prednisolone has been suggested in vitro. However, the selection of the best glucocorticoid for renal transplantation has been seldom considered so far. Thus, the present study was undertaken to compare therapeutic efficacy between prednisolone and methylprednisolone in renal transplantation. We studied 42 renal transplant recipients who were operated on between 1990 and 1994. The patients were divided into two treatment groups: a methylprednisolone/ cyclosporine group (n = 19) and a prednisolone/cyclosporine group (n = 23). Clinical outcome and drug side effects were compared retrospectively between the treatment groups 24-84 months after transplantation. The overall graft survival time in patients treated with methylprednisolone/cyclosporine was superior to that in patients treated with prednisolone/cyclosporine (p < 0.05). Among the recipients from cadaver donors, 5/16 (31.3%) treated with prednisolone required nephrectomy, whereas none of the 10 patients treated with methylprednisolone received nephrectomy (p < 0.01). An examination of the recipients from living related donors revealed that serum creatinine levels 24-36 months after operation were significantly lower in the methylprednisolone group (p < 0.05). Cyclosporine trough levels and glucocorticoid side effects were similar between the treatment groups. The results raised the possibility that methylprednisolone is superior to prednisolone when combined with cyclosporine for maintenance immunosuppressive therapy in renal transplantation.

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“…Keogh et al [5] ob served that a massive dose of méthylpred nisolone was more potent than the ordi nary dose of prednisolone in reducing the neutrophile component of the bronchial lavage fluid in patients with fibrosing alveolitis. A larger fraction of méthylpred nisolone than prednisolone was found in the bronchial lavage fluid after intrave nous administration [6].…”

Section: Introductionmentioning

confidence: 89%

High-Dose Intravenous Methylprednisolone Pulse Therapy as Initial Treatment in Cryptogenic Fibrosing Alveolitis

Gulsvik

Kjelsberg²,

Bergmann³

et al. 1986

Respiration

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Ten patients with fibrosing alveolitis were treated in a simple random design initially with either a high dose of methylprednisolone (5 patients) or a conventional dose of prednisolone (5 patients) followed by a maintenance dose of 30 mg prednisolone daily. The patients were followed for 6 weeks. No significant (p > 0.05) differences were observed between patients with high and low initial dose of glucocorticosteroids, as regards forced vital capacity, transfer factor for carbon monoxide or symptom scores after 3 and 6 weeks of treatment. After 6 weeks the dyspnoea score and the ⁶⁷Ga uptake decreased, on average, by 74 and 85%, respectively, while forced vital capacity and transfer factor increased by 15 and 29%

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Prednisone and Methylprednisolone Disposition in the Lung

Cited by 55 publications

References 11 publications

Methylprednisolone or Dexamethasone, Which One Is the Superior Corticosteroid in the Treatment of Hospitalized COVID-19 Patients: A Triple-Blinded Randomized Controlled Trial

Methylprednisolone or Dexamethasone, Which One Is the Superior Corticosteroid in the Treatment of Hospitalized COVID-19 Patients: A Triple-Blinded Randomized Controlled Trial

A comparison of prednisolone and methylprednisolone for renal transplantation

High-Dose Intravenous Methylprednisolone Pulse Therapy as Initial Treatment in Cryptogenic Fibrosing Alveolitis

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Prednisone and Methylprednisolone Disposition in the Lung

Cited by 55 publications

References 11 publications

Methylprednisolone or Dexamethasone, Which One Is the Superior Corticosteroid in the Treatment of Hospitalized&nbsp;COVID-19 Patients: A Triple-Blinded Randomized Controlled Trial

Methylprednisolone or Dexamethasone, Which One Is the Superior Corticosteroid in the Treatment of Hospitalized&nbsp;COVID-19 Patients: A Triple-Blinded Randomized Controlled Trial

A comparison of prednisolone and methylprednisolone for renal transplantation

High-Dose Intravenous Methylprednisolone Pulse Therapy as Initial Treatment in Cryptogenic Fibrosing Alveolitis

Contact Info

Product

Resources

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Methylprednisolone or Dexamethasone, Which One Is the Superior Corticosteroid in the Treatment of Hospitalized COVID-19 Patients: A Triple-Blinded Randomized Controlled Trial

Methylprednisolone or Dexamethasone, Which One Is the Superior Corticosteroid in the Treatment of Hospitalized COVID-19 Patients: A Triple-Blinded Randomized Controlled Trial