how often are glucosteroids used to treat Muscular Dystrophy

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Glucocorticoids are widely used in the treatment of Duchenne Muscular Dystrophy (DMD), the most common degenerative neuromuscular disease. They are considered a standard part of care for most patients with DMD, with clinics often prescribing these medications as soon as patients are diagnosed. The use of glucocorticoids in DMD aims to control symptoms and slow disease progression through their potent anti-inflammatory action. Despite the significant adverse effects associated with long-term use, the clinical efficacy and short-term benefits of steroid use are well established. Prednisone and deflazacort are the glucocorticoids recommended for treating DMD. Prednisone dosages range from 0.75 mg/kg/day to 1.5 mg/kg/day, and deflazacort is prescribed at a dose of 0.9 mg/kg/day. The therapeutic effects of these drugs are believed to be mediated through suppression of cytotoxic T-cell expression from necrotic muscles. However, the lack of prolonged efficacy and the attendant adverse effects of higher-dose steroids limit their use. The timing, methods, and courses of glucocorticoid treatment for DMD are subjects of ongoing research, with the immediate commencement of glucocorticoid treatment following the diagnosis of DMD being highlighted for its importance. Different dosing schedules are used, including daily and high-dose weekends, with the choice of regimen often tailored to the individual patient's needs and the side effects experienced. Despite the challenges associated with their use, including potential side effects like osteoporosis, obesity, short stature, delayed puberty, and adrenal insufficiency, glucocorticoids remain the only medicines known to help maintain strength and function for people living with DMD. The long-term benefits of these drugs, including extending muscle strength and function over years and even decreasing the risk of death, support their continued use as a standard prescribing practice at many clinics.
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