Gewählte Publikation:

SHR Neuro Krebs Kardio Lipid Stoffw Microb

Buttgereit, F; Everding, A; Andreica, I; Kellner, HL; Schuch, F; Weyand, C; Stewart, PM; Merkel, PA; Dejaco, C; Czerwiec, FS; Desai, K; Katz, DA.
Effects of clofutriben, a selective 11β-hydroxysteroid dehydrogenase type 1 inhibitor, on the efficacy and toxicity of prednisolone in patients with polymyalgia rheumatica: a single-blind controlled trial with sequential cohorts.
Ann Rheum Dis. 2025; Doi: 10.1016/j.ard.2025.10.015
PubMed FullText FullText_MUG

 

Co-Autor*innen der Med Uni Graz

Dejaco Christian

Altmetrics:

Dimensions Citations:

Plum Analytics:

Scite (citation analytics):

Abstract:

OBJECTIVES: Glucocorticoids effectively treat many diseases, but toxicity limits their utility. We aimed to learn whether, by reducing active intracellular glucocorticoid exposures, the 11β-hydroxysteroid dehydrogenase type 1 inhibitor clofutriben could selectively reduce glucocorticoid efficacy but reduce toxicity more strongly. We hypothesised that by increasing the prednisolone dose, it might be possible to restore efficacy back to the original level, thereby improving the benefit-risk profile. METHODS: In sequential cohorts, adults with polymyalgia rheumatica received (single blind) prednisolone 10 mg/d with placebo for 2 weeks, then clofutriben with either prednisolone 10, 15, 20, or 30 mg/d for 2 weeks. RESULTS: Forty-nine and 47 participants completed each trial period with evaluable data. Five who received prednisolone 10 mg/d with clofutriben experienced clinical relapse. No clinical relapses occurred during other treatments. Participants reported more severe symptoms and physical disability when prednisolone 10 mg/d or 15 mg/d, but not 20 mg/d or 30 mg/d, was given with clofutriben. Inflammatory biomarkers followed a similar pattern. Across all prednisolone doses, clofutriben coadministration mitigated glucocorticoid-related adverse effects on biomarkers of bone turnover, lipid metabolism, hypercoagulability, and cardiovascular and adrenal function. CONCLUSIONS: Further trials to assess clofutriben's potential to improve the benefit-risk profile of prednisolone are warranted.

© Med Uni Graz • Impressum