From the Guidelines
No, 30 milligrams (mg) of prednisone per day for 7 days without tapering is not a reasonable treatment regimen for severe eczema.
Treatment Considerations
- The use of systemic corticosteroids, such as prednisone, should be limited to severe cases of atopic eczema where other treatment options have been exhausted 1.
- Systemic corticosteroids are not recommended for maintenance treatment and should be used with caution due to potential side effects.
- The decision to use systemic steroids should be made carefully, and oral corticosteroids should be avoided during crises whenever possible 1.
Dosing and Tapering
- While the provided evidence does not specify a recommended dose or duration for prednisone in the treatment of severe eczema, it emphasizes the importance of careful consideration and avoidance of oral corticosteroids during crises 1.
- A treatment regimen of 30 mg of prednisone per day for 7 days without tapering may be too abrupt and could lead to rebound effects or other complications.
- A more gradual tapering schedule is often recommended to minimize the risk of adverse effects and allow for a smoother transition off the medication.
From the Research
Treatment Regimen for Severe Eczema
- The provided studies do not directly address the specific treatment regimen of 30 milligrams (mg) of prednisone per day for 7 days without tapering for severe eczema.
- However, a study 2 compared the efficacy of prednisolone and ciclosporin for severe adult eczema, and found that ciclosporin is significantly more efficacious than prednisolone.
- Another study 3 examined the acute effects of prednisone on inflammation, glucose tolerance, and bone turnover in healthy individuals, and found that prednisone has significant effects on glucose tolerance and bone formation markers within hours of treatment.
- The study 3 used doses of 10,25, and 60 mg of prednisone daily for 7 days, but did not specifically address the treatment of severe eczema.
- A study 4 discussed the use of low-dose prednisone in the management of rheumatoid arthritis, and recommended tapering of prednisone slowly using 1 mg decrements every couple of weeks to a month.
- It is unclear if this tapering regimen would be applicable to the treatment of severe eczema.
Dosage and Tapering
- The study 4 suggested that treatment of inflammation in rheumatoid arthritis should not exceed 10 mg/day of prednisone, and often may need to be given in daily divided doses.
- The study 3 used higher doses of prednisone (10,25, and 60 mg daily) for a shorter duration (7 days), but did not address tapering.
- The study 2 used an initial dose of 0.5-0.8 mg/kg/day of prednisolone for 2 weeks, followed by placebo for 4 weeks.
Compliance and Side Effects
- A study 5 found that multiple sclerosis patients reported excellent compliance with oral prednisone for acute relapses, with a high rate of compliance (94.3%) and a preference for oral medication for future relapses.
- However, this study used a much higher dose of prednisone (1,250 mg daily) for a shorter duration (3-5 days), and may not be directly applicable to the treatment of severe eczema.