cloprednol and Asthma

Cloprednol was used in 18 steroid-dependent patients with chronic reversible bronchial obstruction over a period of 2 years with respect to HPA-axis function and effect on their clinical status. Patients were treated with a single morning dose of 5-12.5 mg orally. 16 patients were maintained clinically satisfactorily with little change in their steroid status. It was concluded that cloprednol was a satisfactory oral steroid in this group of patients when given as a one-daily morning dose.

Topics: Adrenal Cortex Hormones; Adrenal Glands; Adult; Asthma; Clinical Trials as Topic; Female; Humans; Hydrocortisone; Longitudinal Studies; Male; Middle Aged; Pregnenediones; Respiratory Function Tests; Time Factors

Topics: Adolescent; Adrenal Cortex; Adrenal Cortex Hormones; Age Determination by Skeleton; Asthma; Bronchodilator Agents; Cromolyn Sodium; Female; Glucocorticoids; Histamine H1 Antagonists; Humans; Methylprednisolone; Pituitary-Adrenal Function Tests; Prednisone; Pregnenediones

Cloprednol was tested in 25 patients with chronic reversible bronchial obstruction, with respect to changes in hypothalamic-pituitary-adrenal (HPA) axis function and its efficacy on their clinical asthma. Patients were treated by a single morning dose for a 6-month period. The HPA axis function as estimated by fasting plasma cortisol levels did not show any significant changes, but adrenal response, assessed by ACTH stimulation test, was found slightly less at 6 months than at 3 months and at baseline. Pulmonary function tests--FEV1 and Raw--showed some improvement during the trial period. The score of respiratory complaints and symptoms, as well as the subjective status of the patients, showed a trend towards improvement. No significant side effects were observed.

Topics: Adrenal Cortex; Adrenocorticotropic Hormone; Airway Resistance; Asthma; Female; Forced Expiratory Volume; Glucocorticoids; Humans; Hydrocortisone; Hypothalamo-Hypophyseal System; Male; Middle Aged; Pituitary-Adrenal System; Pregnenediones

Cloprednol is a new oral corticosteroid with a short half-life that is presently under investigation for use in asthma. Seventeen steroid-dependent children and adolescents were switched from daily treatment with prednisone to cloprednol for a one-year study. Patients showed a statistically significant improvement in symptoms while receiving cloprednol therapy. Two patients had extraordinarily good responses. Growth trends, bone age, and chest roentgenograms were not remarkably changed by cloprednol. Pulmonary function was stable. There was a significant improvement in fasting morning cortisol levels and ability to respond to metyrapone and adrenocorticotropic hormone (ACTH) challenge. Cloprednol appears to be a promising drug for steroid-dependent patients who require oral corticosteroid therapy.

Topics: Adolescent; Asthma; Beclomethasone; Child; Drug Evaluation; Female; Glucocorticoids; Humans; Male; Pituitary-Adrenal Function Tests; Pituitary-Adrenal System; Prednisone; Pregnenediones; Respiratory Function Tests

Cloprednol is an oral synthetic glucocorticoid with a short serum half-life of 110 minutes. Twenty children who had chronic corticosteroid-dependent asthma were empaneled to study the effects of cloprednol for a period of 24 months. Three of these dropped out at the end of one year. Alternate-day doses of prednisone were replaced by equivalent daily 8 am doses of cloprednol. Ten of 17 patients had better control during cloprednol therapy than during previous prednisone regimens, and significant improvement was noted in peak expiratory flow rate during the study period (P less than .001). Long-term side effects were absent. Improvement in the degree of hypothalamopituitary adrenal axis responsiveness, based on fasting 8 am cortisol levels, was noted from baseline to the end of study period.

Topics: Administration, Oral; Adolescent; Asthma; Child; Chronic Disease; Drug Tolerance; Female; Glucocorticoids; Humans; Hypothalamo-Hypophyseal System; Male; Methods; Prednisolone; Pregnenediones; Time Factors

Efficacy and safety of alternate-day prednisolone compared to single daily cloprednol were evaluated over a six-week period in 11 children with severe asthma requiring in-residence medical supervision and long-term corticosteroid therapy. Clinical indices of efficacy, including daily pulmonary symptom scores, number of asthma attacks, asthma severity scores, and bronchodilator usage, all favored cloprednol. Afternoon pulmonary function tests (FEV1, FVC, and PEFR) were all significantly improved during the cloprednol period. Although plasma cortisol values remained within the broad range of normal during the cloprednol period, mean values were consistent with partial pituitary-adrenal suppression similar in degree to that observed 24 hours after administration of an alternate-day program of prednisolone therapy. The results of this trial showed cloprednol in single daily doses to be more effective than prednisolone in alternate doses for the treatment of children with severe asthma.

Topics: Adolescent; Asthma; Child; Female; Glucocorticoids; Humans; Male; Prednisolone; Pregnenediones; Respiratory Function Tests; Time Factors