Development of an evidence-based regimen of prednisolone to treat giant cell arteritis - the Norwich regimen

Mukhtyar, Chetan, Cate, Heidi, Graham, Conor, Merry, Peter, Mills, Karen, Misra, Aseema and Jones, Colin (2019) Development of an evidence-based regimen of prednisolone to treat giant cell arteritis - the Norwich regimen. Rheumatology Advances in Practice, 3 (1). ISSN 2514-1775

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Abstract

We have reviewed the literature to form a bespoke regimen for daily oral prednisolone (DP) in GCA. Initial DP in clinical trials is 40-60 mg daily, but relapse rates are 67-92%. Cumulative prednisolone (CP) of 3.2 and 3.9 g (at 6 months) resulted in a relapse rate of 83 and 67%, respectively; and 3 and 3.9 g (at 12 months) resulted in 92 and 82% relapse, respectively. CP was 6.2-7.1 g in the first year. Mean DP was 18.8 mg at 3 months and 6.6-7.4 mg at 12 months. The duration of treatment with prednisolone for GCA was 22-26 months. The CP to achieve discontinuation was 6.5-12.1 g. Using these data, the Norwich regimen starts DP at 1 mg/kg/day of lean body mass, discontinuing over 100 weeks. For the average UK woman, initial DP is 45 mg daily, reaching 21 mg daily by 12 weeks and 6 mg daily by 52 weeks. The CP for the average UK woman would be 6.5 g at 52 weeks and 7.4 g to discontinuation.

Item Type: Article
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: LivePure Connector
Date Deposited: 27 Nov 2019 01:59
Last Modified: 30 Jun 2020 00:03
URI: https://ueaeprints.uea.ac.uk/id/eprint/73081
DOI: 10.1093/rap/rkz001

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