From the FDA Drug Label
The initial dosage of PredniSONE tablets may vary from 5 mg to 60 mg per day, depending on the specific disease entity being treated. In situations of less severity lower doses will generally suffice, while in selected patients higher initial doses may be required The initial dosage should be maintained or adjusted until a satisfactory response is noted.
The best course of oral prednisone for a severe atopic dermatitis flare is to start with a dose between 5 mg to 60 mg per day, with the exact dose depending on the individual patient's response to the treatment 1.
- Key considerations:
- The dose should be adjusted until a satisfactory response is noted
- Higher initial doses may be required for more severe disease states
- The goal is to find the lowest effective dose to maintain an adequate clinical response
- Monitoring: constant monitoring is needed to adjust the dosage as necessary, taking into account changes in clinical status and patient exposure to stressful situations 1.
From the Research
Treatment Options for Severe Atopic Dermatitis Flare
- The use of oral prednisone for severe atopic dermatitis flare is not recommended as a first-line treatment, as evidenced by a study comparing prednisolone and ciclosporin for severe adult eczema, which found that ciclosporin is significantly more efficacious than prednisolone 2.
- Topical corticosteroids are the first-line treatment for atopic dermatitis flare-ups, with newer medications such as crisaborole and dupilumab also being effective but currently cost-prohibitive for most patients 3.
- The use of systemic corticosteroids may exacerbate the acute phase of atopic dermatitis, mediated by IgE, accentuating the Th2 pattern in these patients, and may lead to a rebound phenomenon after cessation of therapy or dose reduction 4.
Management of Atopic Dermatitis Flares
- Management of flares is crucial in atopic dermatitis, and prevention is a key aim of long-term disease control 5.
- The definition of a flare is not always satisfactory or unambiguous, and needs clarification to provide adequate control of the disease through patient education and appropriate treatment 5.
- Treatment of atopic dermatitis flares may involve the use of topical corticosteroids, topical calcineurin inhibitors, ultraviolet phototherapy, and antistaphylococcal antibiotics, depending on the severity of the flare and the patient's response to treatment 3.