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Prednisone has been shown to improve strength in Duchenne dystrophy. Azathioprine often benefits corticosteroid-responsive diseases and can reduce the dose of prednisone needed.The present study reports a randomized,controlled trial of prednisone and azathioprine designed to assess the longer-term effects of prednisone and to determine whether azathioprine alone,or in combination with prednisone,improves strength. Ninety-nine boys(aged five to 15 years)with Duchenne dystrophy were randomized to one of three groups:(I)placebo;(II)prednisone 0.3 mg/kg/d;or (III)prednisone 0.75 mg/kg/d.After 6 months,azathioprine 2 to 2.5 mg/kg/d was added in groups I and II and placebo added in group III.The study showed that the beneficial effect of prednisone(0.75 mg/kg/d)is maintained for at least 18 months and is associated with a 36%increase in muscle mass.There was weight gain,growth retardation,and other side effects. Azathioprine did not have a beneficial effect.This study suggests that prednisone's beneficial effect is not due to immunosuppression. |
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