Use of Oral Corticosteroids to Treat HTLV-1-Associated Myelopathy (HAM) in São Paulo, Brazil
Background: During the development of human T-cell lymphotropic virus (HTLV-1)-associated myelopathy (HAM), the inflammatory phenomenon is very prominent and is a major factor in the outcome of the disease. The use of corticosteroids can modify their natural history, and in this study, we evaluated...
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MDPI AG
2023-05-01
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| author | Flavia Esper Dahy Tatiane Assone Rosa M. N. Marcusso João V. Luisi de Moura Michel E. J. Haziot Jose E. Vidal Jerusa Smid Augusto C. Penalva de Oliveira Jorge Casseb |
| author_facet | Flavia Esper Dahy Tatiane Assone Rosa M. N. Marcusso João V. Luisi de Moura Michel E. J. Haziot Jose E. Vidal Jerusa Smid Augusto C. Penalva de Oliveira Jorge Casseb |
| author_sort | Flavia Esper Dahy |
| collection | DOAJ |
| description | Background: During the development of human T-cell lymphotropic virus (HTLV-1)-associated myelopathy (HAM), the inflammatory phenomenon is very prominent and is a major factor in the outcome of the disease. The use of corticosteroids can modify their natural history, and in this study, we evaluated the effectiveness of using daily low-dose prednisone. Methods: This was a cross-sectional study using data collected by physicians monitoring patients with HAM at the Institute of Infectious Diseases “Emilio Ribas”, the main referral center for patients with infectious diseases in São Paulo, Brazil. The objective was to determine if daily low-dose oral prednisone would be able to stabilize the progression of HAM. The outcome measure was a change in the Osame Motor Disability Score (OMDS). Results: Fifty-four patients used treatment with oral prednisone, 5 milligrams daily. Nine cases were excluded from the study because they did not have at least two rating scales within a minimum interval of one year, and six were excluded for being co-infected with HIV and/or HCV. Thirty-nine patients met this criterion and were included for analysis. The majority were women (71.8%), the mean age was 56.51 years old (SD ± 9.74), and the median time of use of prednisone was 16 months. Thirty-two patients (82.05%) maintained the same OMDS, 5/39 (12.82%) had clinical worsening, and 2/39 (5.13%) improved. Conclusions: There was a trend toward clinical stability with the use of oral corticosteroids. However, randomized controlled trials are necessary to evaluate the use in clinical practices in all stages of HAM. |
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| last_indexed | 2024-03-11T02:09:13Z |
| publishDate | 2023-05-01 |
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| series | Microbiology Research |
| spelling | doaj.art-6581627489304c1e9b34378aa110ae562023-11-18T11:38:10ZengMDPI AGMicrobiology Research2036-74812023-05-0114264665510.3390/microbiolres14020046Use of Oral Corticosteroids to Treat HTLV-1-Associated Myelopathy (HAM) in São Paulo, BrazilFlavia Esper Dahy0Tatiane Assone1Rosa M. N. Marcusso2João V. Luisi de Moura3Michel E. J. Haziot4Jose E. Vidal5Jerusa Smid6Augusto C. Penalva de Oliveira7Jorge Casseb8Department of Neurology, Institute of Infectious Diseases “Emilio Ribas”, São Paulo 01246-000, BrazilLaboratory of Medical Investigation (LIM56) of the School of Medicine/Institute de Tropical Medicine–Department of Dermatology, São Paulo University, São Paulo 05403-000, BrazilDepartment of Neurology, Institute of Infectious Diseases “Emilio Ribas”, São Paulo 01246-000, BrazilDepartment of Neurology, Institute of Infectious Diseases “Emilio Ribas”, São Paulo 01246-000, BrazilDepartment of Neurology, Institute of Infectious Diseases “Emilio Ribas”, São Paulo 01246-000, BrazilDepartment of Neurology, Institute of Infectious Diseases “Emilio Ribas”, São Paulo 01246-000, BrazilDepartment of Neurology, Institute of Infectious Diseases “Emilio Ribas”, São Paulo 01246-000, BrazilDepartment of Neurology, Institute of Infectious Diseases “Emilio Ribas”, São Paulo 01246-000, BrazilLaboratory of Medical Investigation (LIM56) of the School of Medicine/Institute de Tropical Medicine–Department of Dermatology, São Paulo University, São Paulo 05403-000, BrazilBackground: During the development of human T-cell lymphotropic virus (HTLV-1)-associated myelopathy (HAM), the inflammatory phenomenon is very prominent and is a major factor in the outcome of the disease. The use of corticosteroids can modify their natural history, and in this study, we evaluated the effectiveness of using daily low-dose prednisone. Methods: This was a cross-sectional study using data collected by physicians monitoring patients with HAM at the Institute of Infectious Diseases “Emilio Ribas”, the main referral center for patients with infectious diseases in São Paulo, Brazil. The objective was to determine if daily low-dose oral prednisone would be able to stabilize the progression of HAM. The outcome measure was a change in the Osame Motor Disability Score (OMDS). Results: Fifty-four patients used treatment with oral prednisone, 5 milligrams daily. Nine cases were excluded from the study because they did not have at least two rating scales within a minimum interval of one year, and six were excluded for being co-infected with HIV and/or HCV. Thirty-nine patients met this criterion and were included for analysis. The majority were women (71.8%), the mean age was 56.51 years old (SD ± 9.74), and the median time of use of prednisone was 16 months. Thirty-two patients (82.05%) maintained the same OMDS, 5/39 (12.82%) had clinical worsening, and 2/39 (5.13%) improved. Conclusions: There was a trend toward clinical stability with the use of oral corticosteroids. However, randomized controlled trials are necessary to evaluate the use in clinical practices in all stages of HAM.https://www.mdpi.com/2036-7481/14/2/46human T-lymphotropic virus 1HTLV-1-associated myelopathyprednisonetreatmentBrazil |
| spellingShingle | Flavia Esper Dahy Tatiane Assone Rosa M. N. Marcusso João V. Luisi de Moura Michel E. J. Haziot Jose E. Vidal Jerusa Smid Augusto C. Penalva de Oliveira Jorge Casseb Use of Oral Corticosteroids to Treat HTLV-1-Associated Myelopathy (HAM) in São Paulo, Brazil Microbiology Research human T-lymphotropic virus 1 HTLV-1-associated myelopathy prednisone treatment Brazil |
| title | Use of Oral Corticosteroids to Treat HTLV-1-Associated Myelopathy (HAM) in São Paulo, Brazil |
| title_full | Use of Oral Corticosteroids to Treat HTLV-1-Associated Myelopathy (HAM) in São Paulo, Brazil |
| title_fullStr | Use of Oral Corticosteroids to Treat HTLV-1-Associated Myelopathy (HAM) in São Paulo, Brazil |
| title_full_unstemmed | Use of Oral Corticosteroids to Treat HTLV-1-Associated Myelopathy (HAM) in São Paulo, Brazil |
| title_short | Use of Oral Corticosteroids to Treat HTLV-1-Associated Myelopathy (HAM) in São Paulo, Brazil |
| title_sort | use of oral corticosteroids to treat htlv 1 associated myelopathy ham in sao paulo brazil |
| topic | human T-lymphotropic virus 1 HTLV-1-associated myelopathy prednisone treatment Brazil |
| url | https://www.mdpi.com/2036-7481/14/2/46 |
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