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Rejection incidence likely to get increased in early steroid withdrawal cases

February 16, 2010  |  Posted in  Steroids Blog

Rejection incidence likely to get increased in early steroid withdrawal casesWhen steroids are withdrawn at an early stage after transplantation of the liver, there is an increased incidence of rejection and reduced incidence of glucose intolerance necessitating treatment for diabetes, according to a study.

The study was published in an issue of Liver Transplantation, the official journal of the American Association for the Study of Liver Diseases (AASLD) and the International Liver Transplantation Society (ILTS).

From News-Medical.Net:

“Although the incidence of acute rejection in the placebo group was increased, it was easily controlled in most of the cases and did not affect long-term graft histology or survival,” the authors note, adding that the increase may ultimately be acceptable if steroids could be eliminated. However, the main goal of steroid elimination is to reduce metabolic complications and this study showed no difference in cholesterol or hypertension, with a trend toward a decreased incidence of diabetes in the placebo group.

The authors conclude: “Indeed, while there are many arguments in favor of corticosteroid withdrawal beyond 3 months posttransplantation, in terms of safety and efficacy, our study demonstrates that earlier withdrawal at day 14 is not completely safe in terms of rejection, but seems efficient in terms of improvement of glucose tolerability,” which could decrease long-term mortality due to cardiovascular disease.

The finding was disclosed in this first double-blind placebo-controlled study aimed at examining the effects of early steroid withdrawal.

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