High-Dose Steroids Don't Aid Infants With Biliary Atresia
(HealthDay News) — High-dose steroids do not yield large treatment differences in infants with biliary atresia who have had hepatoportoenterostomy, according to a study published in the May 7 issue of the Journal of the American Medical Association, a theme issue on child health. This issue was released early to coincide with the annual meeting of the Pediatric Academic Societies, held from May 3–6 in Vancouver, Canada.
Jorge A. Bezerra, MD, from Cincinnati Children's Hospital Medical Center, and colleagues randomized 140 infants (mean age, 2.3 months) to receive intravenous methylprednisolone (4mg/kg/d for two weeks) and oral prednisolone (2mg/kg/d for two weeks; 70 patients) or placebo (70 patients). Treatment was initiated within 72 hours of hepatoportoenterostomy.
The researchers found that bile drainage was not statistically significantly improved by steroids at six months post-hepatoportoenterostomy (adjusted relative risk, 1.14; P=0.43). At 24 months of age, transplant-free survival was also similar between the groups (adjusted hazard ratio, 1.0; P=0.99). While the percentage of participants with serious adverse events was similar between the groups (P>0.99), participants receiving steroids had an earlier onset of their first serious adverse event by 30 days post-hepatoportoenterostomy (P=0.008).
"Among infants with biliary atresia who have undergone hepatoportoenterostomy, high-dose steroid therapy following surgery did not result in statistically significant treatment differences in bile drainage at six months," Bezerra and colleagues conclude.
The pharmaceutical industry contributed funding to the study; several authors disclosed financial ties to pharmaceutical companies.