Benefícios a longo prazo do tratamento com deflazacort em meninos com distrofia muscular de Duchenne na segunda década de vida.
Canadá – o estudo compara os meninos com distrofia muscular de Duchenne na segunda década de vida tratados com deflazacort, uma forma de corticóide (40 meninos) com os não tratados (34 meninos). Os tratados com corticóide mantiveram força muscular maior, maior capacidade respiratória, menor problemas para alimentação, menor grau de escoliose, melhor função pulmonar e maior sobrevida. Os efeitos colaterais mais observados com o tratamento foram menor estatura, maior aumento de peso, fraturas e catarata.
O resumo em inglês do artigo recentemente publicado pode ser lido abaixo: (IN PRESS: Neuromuscular Disorders, 2006) Long-term benefits of deflazacort treatment for boys with Duchenne muscular dystrophy in their second decade
W.D. Biggar, V.A. Harris, L. Eliasoph, B. Alman – Canada
We compare the clinical course of 74 boys 10–18 years of age with Duchenne muscular dystrophy (DMD) treated (40) and not treated (34) with deflazacort. Treated boys were able to rise from supine to standing, climb stairs and walk 10 m without aids, 3–5 years longer than boys not treated. After 10 years of age, treated boys had significantly better pulmonary function than boys not treated and after15 years of age, 8 of 17 boys not treated required nocturnal ventilation (treated 0 of 40). For boys over 15 years of age, 11 of 17 boys not treated required assistance with feeding compared to none of the treated boys. By 18 years, 30 of 34 boys not treated had a spinal curve greater than 20o compared to 4 of 40 treated boys. By 18 years, 7 of 34 boys not treated had lost 25% or more of their body weight (treated 0 of 40) and 4 of those 7 boys required a gastric feeding tube. By 18 years, 20 of 34 boys not treated had cardiac left ventricular ejection fractions less than 45% compared to 4 of 40 treated boys and 12 of 34 died in their second decade (mean 17.6+1.7 years) primarily of cardiorespiratory complications. Two of 40 boys treated with deflazacort died at 13 and 18 years of age from cardiac failure. The treated boys were significantly shorter, did not have excessive weight gain and 22 of 40 had asymptomatic cataracts. Long bone fractures occurred in 25% of boys in both the treated and not treated groups. This longer-term study demonstrates that deflazacort has a very significant impact on health, quality of life and health care costs for boys with DMD and their families, and is associated with few side effects.
Fonte: http://www.distrofiamuscular.net/noticias.htm
