Deleterious Effect of Prednisolone in HBsAg-positive Chronic Active Hepatitis
To study the efficacy of corticosteroids in chronic active hepatitis (CAH) positive for hepatitis B surface antigen (HBsAg), we pair-randomized 51 patients to receive either 15 to 20 mg of prednisolone per day or a placebo. After initial remission, the maintenance dosage of prednisolone was 10 mg pe...
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| Veröffentlicht in: | The New England journal of medicine 1981-02, Vol.304 (7), p.380-386 |
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| creator | Lam, Kui Chun Lai, Ching Lung Ng, R. P Trepo, Christian Wu, P. C |
| description | To study the efficacy of corticosteroids in chronic active hepatitis (CAH) positive for hepatitis B surface antigen (HBsAg), we pair-randomized 51 patients to receive either 15 to 20 mg of prednisolone per day or a placebo. After initial remission, the maintenance dosage of prednisolone was 10 mg per day, and the patients were prospectively followed for up to 3 1/2 years. Prednisolone decreased serum bilirubin (P |
| doi_str_mv | 10.1056/NEJM198102123040702 |
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| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_1870014230</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>4315774621</sourcerecordid><originalsourceid>FETCH-LOGICAL-c467t-a728c7d5c836d8fb020c867e11f1491c0ed729a41a49feccf82a78fbd817618d2</originalsourceid><addsrcrecordid>eNp9UMFOwzAMjRBojMEXIKRKHFHBTrMmPY4xGGgDDnCuutSBTmszkhaJvydjEyeEL5b1np-fH2OnCJcIw_TqcfIwx0whcOQJCJDA91gfh0kSCwHpPusDcBULmSWH7Mj7JYRCkfVYT0IQkKrP5je0opZcZTsfTYwh3UbWRM-OyqbydmUbiqomml770Vu8tr5qq0-Kxu_ONpWORvpnnNK6aAPij9mBKVaeTnZ9wF5vJy_jaTx7ursfj2axFqls40JypWU51CpJS2UWwEGrVBKiCfZQA5WSZ4XAQmTBkTaKFzLwSoUyRVXyATvf6q6d_ejIt_nSdq4JJ3NUcvNkCCSwki1LO-u9I5OvXVUX7itHyDcJ5n8kGLbOdtrdoqbyd2cXWcAvtnhd-7yhZf2v2jdHdXa_</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1870014230</pqid></control><display><type>article</type><title>Deleterious Effect of Prednisolone in HBsAg-positive Chronic Active Hepatitis</title><source>MEDLINE</source><creator>Lam, Kui Chun ; Lai, Ching Lung ; Ng, R. P ; Trepo, Christian ; Wu, P. C</creator><creatorcontrib>Lam, Kui Chun ; Lai, Ching Lung ; Ng, R. P ; Trepo, Christian ; Wu, P. C</creatorcontrib><description><![CDATA[To study the efficacy of corticosteroids in chronic active hepatitis (CAH) positive for hepatitis B surface antigen (HBsAg), we pair-randomized 51 patients to receive either 15 to 20 mg of prednisolone per day or a placebo. After initial remission, the maintenance dosage of prednisolone was 10 mg per day, and the patients were prospectively followed for up to 3 1/2 years. Prednisolone decreased serum bilirubin (P<0.05) and globulin (P<0.01) at three months; it delayed other biochemical remission occurring after the second month of medication (P<0.001); it hastened biochemical relapse (P<0.0001); and it increased the frequency of complications (P<0.0001) and the death rate (P<0.01). We conclude that prednisolone has an overall harmful effect in patients with HBsAg-positive CAH. (N Engl J Med. 1981; 304:380–6.)
THE beneficial effects of corticosteroids in chronic active hepatitis (CAH) have been so well established in Australia,
1
England,
2
and America
3
that this group of drugs has become the mainstay of treatment for CAH. The conclusions are so strong that withholding corticosteroids from these patients has been considered unethical.
2
However, the cases in these series have usually been negative for hepatitis B surface antigen (HBsAg). In HBsAg-positive cases, the response to prednisolone has recently been found to be less satisfactory than that in HBsAg-negative cases.
4
Whether corticosteroids are effective at all in HBsAg-positive disease is still open to question.
5
There is . . .]]></description><identifier>ISSN: 0028-4793</identifier><identifier>EISSN: 1533-4406</identifier><identifier>DOI: 10.1056/NEJM198102123040702</identifier><identifier>PMID: 7005678</identifier><language>eng</language><publisher>United States: Massachusetts Medical Society</publisher><subject>Adult ; Alanine Transaminase - blood ; Aspartate Aminotransferases - blood ; Bilirubin - blood ; Biopsy ; Chronic Disease ; Clinical Trials as Topic ; Corticosteroids ; Diabetes ; Drug dosages ; Endoscopy ; Female ; Hepatitis ; Hepatitis - drug therapy ; Hepatitis B - drug therapy ; Hepatitis B Surface Antigens - analysis ; Hospitals ; Humans ; Laboratories ; Male ; Middle Aged ; Patients ; Prednisolone - adverse effects ; Prednisolone - therapeutic use ; Prospective Studies ; Random Allocation ; Remission, Spontaneous ; Serum Globulins - analysis ; Tuberculosis ; Urine</subject><ispartof>The New England journal of medicine, 1981-02, Vol.304 (7), p.380-386</ispartof><rights>Copyright Massachusetts Medical Society Feb 12, 1981</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c467t-a728c7d5c836d8fb020c867e11f1491c0ed729a41a49feccf82a78fbd817618d2</citedby><cites>FETCH-LOGICAL-c467t-a728c7d5c836d8fb020c867e11f1491c0ed729a41a49feccf82a78fbd817618d2</cites></display><links><openurl>$$Topenurl_article</openurl><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>776</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/7005678$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lam, Kui Chun</creatorcontrib><creatorcontrib>Lai, Ching Lung</creatorcontrib><creatorcontrib>Ng, R. P</creatorcontrib><creatorcontrib>Trepo, Christian</creatorcontrib><creatorcontrib>Wu, P. C</creatorcontrib><title>Deleterious Effect of Prednisolone in HBsAg-positive Chronic Active Hepatitis</title><title>The New England journal of medicine</title><addtitle>N Engl J Med</addtitle><description><![CDATA[To study the efficacy of corticosteroids in chronic active hepatitis (CAH) positive for hepatitis B surface antigen (HBsAg), we pair-randomized 51 patients to receive either 15 to 20 mg of prednisolone per day or a placebo. After initial remission, the maintenance dosage of prednisolone was 10 mg per day, and the patients were prospectively followed for up to 3 1/2 years. Prednisolone decreased serum bilirubin (P<0.05) and globulin (P<0.01) at three months; it delayed other biochemical remission occurring after the second month of medication (P<0.001); it hastened biochemical relapse (P<0.0001); and it increased the frequency of complications (P<0.0001) and the death rate (P<0.01). We conclude that prednisolone has an overall harmful effect in patients with HBsAg-positive CAH. (N Engl J Med. 1981; 304:380–6.)
THE beneficial effects of corticosteroids in chronic active hepatitis (CAH) have been so well established in Australia,
1
England,
2
and America
3
that this group of drugs has become the mainstay of treatment for CAH. The conclusions are so strong that withholding corticosteroids from these patients has been considered unethical.
2
However, the cases in these series have usually been negative for hepatitis B surface antigen (HBsAg). In HBsAg-positive cases, the response to prednisolone has recently been found to be less satisfactory than that in HBsAg-negative cases.
4
Whether corticosteroids are effective at all in HBsAg-positive disease is still open to question.
5
There is . . .]]></description><subject>Adult</subject><subject>Alanine Transaminase - blood</subject><subject>Aspartate Aminotransferases - blood</subject><subject>Bilirubin - blood</subject><subject>Biopsy</subject><subject>Chronic Disease</subject><subject>Clinical Trials as Topic</subject><subject>Corticosteroids</subject><subject>Diabetes</subject><subject>Drug dosages</subject><subject>Endoscopy</subject><subject>Female</subject><subject>Hepatitis</subject><subject>Hepatitis - drug therapy</subject><subject>Hepatitis B - drug therapy</subject><subject>Hepatitis B Surface Antigens - analysis</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Laboratories</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>Prednisolone - adverse effects</subject><subject>Prednisolone - therapeutic use</subject><subject>Prospective Studies</subject><subject>Random Allocation</subject><subject>Remission, Spontaneous</subject><subject>Serum Globulins - analysis</subject><subject>Tuberculosis</subject><subject>Urine</subject><issn>0028-4793</issn><issn>1533-4406</issn><fulltext>false</fulltext><rsrctype>article</rsrctype><creationdate>1981</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9UMFOwzAMjRBojMEXIKRKHFHBTrMmPY4xGGgDDnCuutSBTmszkhaJvydjEyeEL5b1np-fH2OnCJcIw_TqcfIwx0whcOQJCJDA91gfh0kSCwHpPusDcBULmSWH7Mj7JYRCkfVYT0IQkKrP5je0opZcZTsfTYwh3UbWRM-OyqbydmUbiqomml770Vu8tr5qq0-Kxu_ONpWORvpnnNK6aAPij9mBKVaeTnZ9wF5vJy_jaTx7ursfj2axFqls40JypWU51CpJS2UWwEGrVBKiCfZQA5WSZ4XAQmTBkTaKFzLwSoUyRVXyATvf6q6d_ejIt_nSdq4JJ3NUcvNkCCSwki1LO-u9I5OvXVUX7itHyDcJ5n8kGLbOdtrdoqbyd2cXWcAvtnhd-7yhZf2v2jdHdXa_</recordid><startdate>19810212</startdate><enddate>19810212</enddate><creator>Lam, Kui Chun</creator><creator>Lai, Ching Lung</creator><creator>Ng, R. P</creator><creator>Trepo, Christian</creator><creator>Wu, P. C</creator><general>Massachusetts Medical Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0TZ</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BEC</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K0Y</scope><scope>LK8</scope><scope>M0R</scope><scope>M0T</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2P</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope></search><sort><creationdate>19810212</creationdate><title>Deleterious Effect of Prednisolone in HBsAg-positive Chronic Active Hepatitis</title><author>Lam, Kui Chun ; Lai, Ching Lung ; Ng, R. P ; Trepo, Christian ; Wu, P. C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c467t-a728c7d5c836d8fb020c867e11f1491c0ed729a41a49feccf82a78fbd817618d2</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1981</creationdate><topic>Adult</topic><topic>Alanine Transaminase - blood</topic><topic>Aspartate Aminotransferases - blood</topic><topic>Bilirubin - blood</topic><topic>Biopsy</topic><topic>Chronic Disease</topic><topic>Clinical Trials as Topic</topic><topic>Corticosteroids</topic><topic>Diabetes</topic><topic>Drug dosages</topic><topic>Endoscopy</topic><topic>Female</topic><topic>Hepatitis</topic><topic>Hepatitis - drug therapy</topic><topic>Hepatitis B - drug therapy</topic><topic>Hepatitis B Surface Antigens - analysis</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Laboratories</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Patients</topic><topic>Prednisolone - adverse effects</topic><topic>Prednisolone - therapeutic use</topic><topic>Prospective Studies</topic><topic>Random Allocation</topic><topic>Remission, Spontaneous</topic><topic>Serum Globulins - analysis</topic><topic>Tuberculosis</topic><topic>Urine</topic><toplevel>peer_reviewed</toplevel><creatorcontrib>Lam, Kui Chun</creatorcontrib><creatorcontrib>Lai, Ching Lung</creatorcontrib><creatorcontrib>Ng, R. 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P</au><au>Trepo, Christian</au><au>Wu, P. C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Deleterious Effect of Prednisolone in HBsAg-positive Chronic Active Hepatitis</atitle><jtitle>The New England journal of medicine</jtitle><addtitle>N Engl J Med</addtitle><date>1981-02-12</date><risdate>1981</risdate><volume>304</volume><issue>7</issue><spage>380</spage><epage>386</epage><pages>380-386</pages><issn>0028-4793</issn><eissn>1533-4406</eissn><abstract><![CDATA[To study the efficacy of corticosteroids in chronic active hepatitis (CAH) positive for hepatitis B surface antigen (HBsAg), we pair-randomized 51 patients to receive either 15 to 20 mg of prednisolone per day or a placebo. After initial remission, the maintenance dosage of prednisolone was 10 mg per day, and the patients were prospectively followed for up to 3 1/2 years. Prednisolone decreased serum bilirubin (P<0.05) and globulin (P<0.01) at three months; it delayed other biochemical remission occurring after the second month of medication (P<0.001); it hastened biochemical relapse (P<0.0001); and it increased the frequency of complications (P<0.0001) and the death rate (P<0.01). We conclude that prednisolone has an overall harmful effect in patients with HBsAg-positive CAH. (N Engl J Med. 1981; 304:380–6.)
THE beneficial effects of corticosteroids in chronic active hepatitis (CAH) have been so well established in Australia,
1
England,
2
and America
3
that this group of drugs has become the mainstay of treatment for CAH. The conclusions are so strong that withholding corticosteroids from these patients has been considered unethical.
2
However, the cases in these series have usually been negative for hepatitis B surface antigen (HBsAg). In HBsAg-positive cases, the response to prednisolone has recently been found to be less satisfactory than that in HBsAg-negative cases.
4
Whether corticosteroids are effective at all in HBsAg-positive disease is still open to question.
5
There is . . .]]></abstract><cop>United States</cop><pub>Massachusetts Medical Society</pub><pmid>7005678</pmid><doi>10.1056/NEJM198102123040702</doi><tpages>7</tpages></addata></record> |
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| ispartof | The New England journal of medicine, 1981-02, Vol.304 (7), p.380-386 |
| issn | 0028-4793 1533-4406 |
| language | eng |
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| source | MEDLINE |
| subjects | Adult Alanine Transaminase - blood Aspartate Aminotransferases - blood Bilirubin - blood Biopsy Chronic Disease Clinical Trials as Topic Corticosteroids Diabetes Drug dosages Endoscopy Female Hepatitis Hepatitis - drug therapy Hepatitis B - drug therapy Hepatitis B Surface Antigens - analysis Hospitals Humans Laboratories Male Middle Aged Patients Prednisolone - adverse effects Prednisolone - therapeutic use Prospective Studies Random Allocation Remission, Spontaneous Serum Globulins - analysis Tuberculosis Urine |
| title | Deleterious Effect of Prednisolone in HBsAg-positive Chronic Active Hepatitis |
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