Alternate-Day Prednisone

Publisher Website
Google Scholar
Abstract
The effects of alternate-day and daily prednisone on leukocyte kinetics were studied in 20 patients with inflammatory diseases to investigate the mechanisms of corticosteroid-induced susceptibility to infections. With daily prednisone, both neutrophil and monocyte inflammatory responses were significantly decreased. In patients on alternate-day prednisone, who were studied during the day on which prednisone was administered, neutrophilia and monocytopenia occurred, and cutaneous inflammatory responses of monocytes, but not of neutrophils, were significantly reduced. On the day of therapy of alternate-day prednisone and with daily therapy the half-life of labeled blood neutrophils was significantly prolonged, and the prolongation was proportional to the dose of the drug given. In contrast, in patients maintained on alternate-day prednisone therapy and studied on the day off drug, leukocyte counts, inflammatory responses and neutrophil half-life were normal. (N Engl J Med 291:1154–1158, 1974)