In this section
muscular dystrophy) is a serious neuromuscular
disorder and the most common form of muscular dystrophy in
children. Please see the Kids Health Info factsheet: DMD for more information.
Corticosteroids are the only medicines that
have, so far, been proven to slow the progression of muscle
weakness in children with DMD. Research has
shown corticosteroids help preserve muscle strength and
function longer in boys with DMD, and may also help preserve the heart
and breathing muscles.
Corticosteroids are man-made drugs. They
are similar to the steroid hormone cortisol which is
produced in the body by the adrenal glands.
There are several different types of
corticosteroid. The form most commonly used in Australia
is prednisolone, which comes as a syrup or tablet. Deflazacort is
another corticosteroid which has been shown to be helpful for
children with DMD but it is not widely availalbe in
Recent studies have shown that children with
DMD who take corticosteroids:
It's important to note that the benefit of
treatment with corticosteroids varies between children. Strength is
only maintained as long as treatment is continued, and the benefits
of treatment will decrease after treatment is stopped.
Corticosteroids have many possible
side-effects. The chances of these occurring depend on the
individual child and the dose of corticosteroid they are
taking. The most common steroid side-effects are:
Other possible side-effects include difficulty
sleeping, headaches, mild stomach aches, mild acne, and dry skin.
There are also some rare side-effects that you
can discuss with your child's neurologist, including high blood
pressure, diabetes, increased chances of infections, thinner
skin, increased sweating, dizziness, depression, and/or hallucinations.
It is important that you talk about any
possible side-effects with your child's doctor. Always talk with
your GP or neurologist before giving any additional or new
medication, including over-the-counter, complementary or 'natural' medicines.
It is very important that your child does not
suddenly stop taking corticosteroids. The body becomes used
to their effect and needs time to adjust when they are stopped.
Therefore, the dose needs to be reduced slowly.
The right time to start corticosteroids is
different for each child. A decision should be reached after
discussion between the child's parents, doctor and allied heath
It seems children benefit the most by starting
corticosteroids while their muscles are still strong. However, even for
children with advanced muscle weakness, corticosteroids may
still be helpful in increasing the strength of the arms,
lungs and heart.
Checking for side-effectsYour child should have regular general health checks to
keep an eye out for possible steroid side-effects. Health
checks should include:
ImmunisationsMost children should have had all their immunisations by
the time corticosteroid therapy begins. Children taking
corticosteroids should not have live vaccines such as the MMR
(measles, mumps, rubella) vaccine.
If your son has not had chicken pox, it is
important that he has the varicella (chicken pox) vaccination
before starting corticosteroids. Chicken pox infection can be very
severe in children on corticosteroids.
Reducing osteoporosisPlenty of calcium and vitamin D are vital to reduce
osteoporosis in children on long-term corticosteroid treatment. Dietary supplements of vitamin D and calcuim are generally recommended for children on regular steroid therapy.
Minimising weight gainYour child should have a low fat, low salt diet to assist in controlling weight gain. Limit red meats and saturated fats, and encourage fresh
fruit, vegetables, water and fat-free milk. Plenty of sunshine and
exercise is also very helpful in a variety of ways.
Make sure people know your child is
taking corticosteroidsIt is a good idea for your son to wear a MedicAlert
bracelet at all times. You can buy these from the RCH or any
pharmacy. The bracelet should state that he has Duchenne muscular
dystrophy and is taking corticosteroids. If he is very sick or has
an accident, this will tell the doctor treating him about his
condition and the need for intravenous corticosteroids.
This information has been developed to
give you an understanding of corticosteroid use for your son's
condition. It is not intended to replace discussion with your
doctors and other health professionals, so feel free to ask any
questions you may have after reading this.
Developed by the RCH Children's
Neurosciences Centre in consultation with RCH Pharmacy. First
published Dec 2007. Revised October 2010.