JAY H. HOOFNAGLE, M.D.; GARY L. DAVIS, M.D.; S. CHRIS PAPPAS, M.D.; REGINALD G. HANSON, M.D.; MARION PETERS, M.D.; MARK I. AVIGAN, M.D.; JEANNE G. WAGGONER, B.A.; E. ANTHONY JONES, M.D.; LEONARD B. SEEFF, M.D.
Fifteen patients with chronic type B hepatitis were treated with corticosteroids in a randomized, double-blind, placebo-controlled trial lasting 28 days. Ten patients received prednisolone, 60 mg/d for 2 weeks, then 30 mg/d for another 2 weeks; 5 patients received placebo. Serum aminotransferase levels decreased significantly during prednisolone therapy but 4 to 10 weeks after abrupt withdrawal of the drug, they rebounded to levels greater than those before treatment. This exacerbation of disease lasted for several months and was prolonged and symptomatic in 3 patients. Hepatitis B virus levels did not change substantially during treatment. Follow-up examinations showed no improvement in biochemical or serologic features of the disease in any of the 15 patients; follow-up liver biopsies showed a worsening in 4 of 7 treated patients but in 0 of 5 control patients. Thus, a 28-day course of prednisolone produced no beneficial effects in patients with mild-to-moderate chronic type B hepatitis; on the contrary, such treatment may be harmful.
HOOFNAGLE JH, DAVIS GL, PAPPAS SC, et al. A Short Course of Prednisolone in Chronic Type B Hepatitis: Report of a Randomized, Double-Blind, Placebo-Controlled Trial. Ann Intern Med. 1986;104:12–17. doi: 10.7326/0003-4819-104-1-12
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Published: Ann Intern Med. 1986;104(1):12-17.
Gastroenterology/Hepatology, Liver Disease.
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