Background: Deflazacort is an oxazoline derivative of prednisolone with comparable
anti-inflammatory and immunosuppressive actions but fewer side effects. Except for a
few isolated reports, all previous studies with deflazacort have been performed in adult
patients. We therefore performed the study to compare the effectiveness, safety, and
influence on bone and glucose metabolism of deflazacort and prednisolone in pediatric
patients with hematologic diseases requiring long-term glucocorticoid administration.
Methods: We studied 28 patients requiring glucocorticoid for hematologic diseases
newly diagnosed between June 1994 and June 1995 at Seoul National University
Children's Hospital. They had not taken other glucocorticoids before this study.
According to the order of registration, fourteen patients were assigned to receive
prednisolone and next fourteen patients were assigned to receive deflazacort. Height,
weight, and blood pressure were recorded and laboratory investigations were performed
before and after one and three months of the study. Bone mineral density was measured
by dual X-ray absorptiomeoy before and after three months of the study. Comparison
between groups were performed by Student's t-test for paired data and P<0.05 was
considered statistically significant.
Results: There were no significant differences between mean trends for each group
for height, weight, hemoglobin, white blood cell count, and serum levels of calcium,
phosphorus and alkaline phosphatase. Mean fasting blood glucose level was lower in
deflazacort group than in prednisolone group, but this was not statistically significant. In
contrast to prednisolone group in which there was a decrease in mean total bone
mineral density, there was an increase in mean total bone mineral density of deflazacort
group after three months of the study. No correlation was found between dose of
glucocorticoid and change of bone mineral density.
Conclusion: Comparative dose of deflazacort leads to significantly less bone loss than
prednisolone in pediatric patients with hematologic diseases.

Keywords: Deflazacort, Fasting blood glucose, Bone mineral density, Dual X-ray absorptiometry