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Effect of prednisolone on language function in children with autistic spectrum disorder: a randomized clinical trial
Brito, Adriana Rocha; Vairo, Giselle de Paula Teixeira; Dias, Ana Paula Botelho Henriques; Olej, Beni; Nascimento, Osvaldo José Moreira; Vasconcelos, Marcio Moacyr.
  • Brito, Adriana Rocha; Universidade Federal Fluminense. Departamento Materno-Infantil. Niterói. BR
  • Vairo, Giselle de Paula Teixeira; Universidade Federal Fluminense. Departamento Materno-Infantil. Niterói. BR
  • Dias, Ana Paula Botelho Henriques; Universidade Federal Fluminense. Departamento Materno-Infantil. Niterói. BR
  • Olej, Beni; Universidade Federal Fluminense. Departamento de Medicina Clínica. Niterói. BR
  • Nascimento, Osvaldo José Moreira; Universidade Federal Fluminense. Departamento de Medicina Clínica. Niterói. BR
  • Vasconcelos, Marcio Moacyr; Universidade Federal Fluminense. Departamento Materno-Infantil. Niterói. BR
J. pediatr. (Rio J.) ; 97(1): 22-29, Jan.-Feb. 2021. graf
Article in English | LILACS | ID: biblio-1154718
ABSTRACT
Abstract

Objective:

To describe the effect of prednisolone on language in children with autism spectrum disorder. This study is based upon two hypotheses autism etiology may be closely related to neuroinflammation; and, an effective treatment should restore the individual's language skills.

Method:

This is a prospective, double-blinded, randomized, placebo-controlled clinical trial, carried out in a federal university hospital. The initial patient sample consisted of 40 subjects, which were randomized into two parallel groups. Inclusion criteria were male gender, 3-7 years of age, and meeting the Diagnostic and Statistical Manual of Mental Disorders - 4th edition (DSM-IV) diagnostic criteria. The final sample consisted of 38 patients, of whom 20 were randomized to the placebo group and 18 to the active group. The latter received prednisolone for 24 weeks, at an initial dose of 1 mg/kg/day and a tapering dose from the ninth week onward. Language was measured on four occasions over a 12-month period by applying two Brazilian tools the Language Development Assessment (ADL) and the Child Language Test in Phonology, Vocabulary, Fluency, and Pragmatics (ABFW).

Results:

The side effects were mild two patients had hypertension, five had hyperglycemia, and two had varicella. Prednisolone increased the global ADL score in children younger than 5 years of age who had developmental regression (p = 0.0057). The ABFW's total of communicative acts also responded favorably in those participants with regression (p = 0.054). The ABFW's total of vocal acts showed the most significant results, especially in children younger than 5 years (p = 0.004, power = 0.913).

Conclusions:

The benefit of prednisolone for language scores was more evident in participants who were younger than five years, with a history of developmental regression, but the trial's low dose may have limited this benefit. The observed side effects do not contraindicate corticosteroid use in autism.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Autistic Disorder / Autism Spectrum Disorder Type of study: Controlled clinical trial / Practice guideline / Observational study / Risk factors Limits: Child / Humans / Male Country/Region as subject: South America / Brazil Language: English Journal: J. pediatr. (Rio J.) Journal subject: Pediatrics Year: 2021 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade Federal Fluminense/BR

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Full text: Available Index: LILACS (Americas) Main subject: Autistic Disorder / Autism Spectrum Disorder Type of study: Controlled clinical trial / Practice guideline / Observational study / Risk factors Limits: Child / Humans / Male Country/Region as subject: South America / Brazil Language: English Journal: J. pediatr. (Rio J.) Journal subject: Pediatrics Year: 2021 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade Federal Fluminense/BR