caa a22 4500 477056407 CHVBK 20180405111347.0 cr unu---uuuuu 170330e19960901xx s 000 0 eng 10.1007/s002280050160 doi (NATIONALLICENCE)springer-10.1007/s002280050160 Comparison of the pharmacodynamic effects of deflazacort and prednisolone in healthy subjects [Elektronische Daten] [G. Babadjanova, B. Allolio, M. Vollmer, M. Reincke, H. M. Schulte]   Objective: Deflazacort, a synthetic oxazoline derivative of prednisolone, has been suggested as having major advantages over other glucocorticoids, as it is claimed to cause fewer adverse effects at equivalent antiinflammatory potency. The assumed equipotency ratio of deflazacort versus other glucocorticoids is critical for this assumption. Methods: In a randomized cross-over study we compared the acute effects of deflazacort and prednisolone on serum cortisol, osteocalcin, insulin and blood cells (eosinophils and lymphocytes) in normal subjects. On seven occasions separated by a wash out period ≥ 1 week all participants received placebo, prednisolone (8 mg, 20 mg, 40 mg) and deflazacort (12 mg, 30 mg, 60 mg). The medication was given orally at 20.00 h as a single dose. Blood was collected at 8.00 h before and after each medication. Log (dose) response relationships were calculated and were used to compare the drugs. Results: The following equipotent dose ratios (mg deflazacort: mg prednisolone) were found: osteocalcin suppression 1.54, cortisol suppression 2.27, suppression of eosinophils 1.14 and lymphocytes 2.77. As parallelism between regression curves was rejected, equipotency could not be calculated for insulin. In 3 subjects even the highest dose of deflazacort failed to suppress serum cortisol. Conclusion: Our study highlights the difficulties of establishing equipotency ratios for glucocorticoids. It casts doubts on the generally assumed equipotency dose ratio of deflazacort vs prednisolone, as both for cortisol and lymphocytes the 95% CI was > 1.2. Thus, reduced adverse effects during deflazacort therapy may be a consequence of lower effective glucocorticoid dosage. Springer-Verlag Berlin Heidelberg, 1996 Key words Deflazacort nationallicence Prednisolone nationallicence osteocalcin nationallicence cortisol nationallicence blood cells nationallicence equipotency nationallicence Babadjanova G. Schwerpunkt Endokrinologie, Medizinische Universitätsklinik Würzburg, Josef-Schneider-Strasse 2, D-97080 Wuerzburg Germany, DE aut Allolio B. Schwerpunkt Endokrinologie, Medizinische Universitätsklinik Würzburg, Josef-Schneider-Strasse 2, D-97080 Wuerzburg Germany, DE aut Vollmer M. Institut für Hormon- und Fortpflanzungsforschung, Universität Hamburg, Germany, DE aut Reincke M. Schwerpunkt Endokrinologie, Medizinische Universitätsklinik Würzburg, Josef-Schneider-Strasse 2, D-97080 Wuerzburg Germany, DE aut Schulte H. M. Institut für Hormon- und Fortpflanzungsforschung, Universität Hamburg, Germany, DE aut https://doi.org/10.1007/s002280050160 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002280050160 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Babadjanova G. Schwerpunkt Endokrinologie, Medizinische Universitätsklinik Würzburg, Josef-Schneider-Strasse 2, D-97080 Wuerzburg Germany, DE aut NATIONALLICENCE 700 1- Allolio B. Schwerpunkt Endokrinologie, Medizinische Universitätsklinik Würzburg, Josef-Schneider-Strasse 2, D-97080 Wuerzburg Germany, DE aut NATIONALLICENCE 700 1- Vollmer M. Institut für Hormon- und Fortpflanzungsforschung, Universität Hamburg, Germany, DE aut NATIONALLICENCE 700 1- Reincke M. Schwerpunkt Endokrinologie, Medizinische Universitätsklinik Würzburg, Josef-Schneider-Strasse 2, D-97080 Wuerzburg Germany, DE aut NATIONALLICENCE 700 1- Schulte H. M. Institut für Hormon- und Fortpflanzungsforschung, Universität Hamburg, Germany, DE aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer