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04/19/2007 00:42
Bob_Branstetter
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04/19/2007 00:42
Bob_Branstetter
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Steroids
From the Dupuytren's website under Other therapies...
Steroid treatment
Steroid treatment has been reported to reduce the rate of fibroblast cell proliferation and increase the rate of apoptosis (programmed cell death) in nodules of Dupuytren's disease. An overview can be found in this steroid_article and a pathogenesis oriented explanations of its effect in an article by Meek et al. "Dupuytren's disease. A model for the mechanism of fibrosis and its modulation by steroids" J. Bone Joint Surg Br. 81 (1999) p 732-738 link. Another study shows that 50% of patients did experience reactivation of the disease in the nodules 1 to 3 years after the last injection, necessitating 1 or more injections, see steroid_article2. An article from Brazil reports failure of the steroid treatment in a specific case: steroid_failure_article. Patients might consider the danger of a potential atrophy or discoloration of the tissue. A study claims dose dependent loss of bone at the hip in premenopausal women (bone_loss) but has been criticized.
In my opinion, the statement about the last article linked (bone_loss) should be corrected to include the fact that this particular study was not related to injections of steroids for treatment of Dupuytrens. This last study was, in fact, about the treatment of asthma using inhaled triamcinolone acetonide. I fail to see the relevance.
I have received injections of triamcinolone acetonide directly into the cords in my left palm by the author (Dr. Lynn Ketchum) of the second study linked. The cords in this hand have softened dramatically. While there is always a danger of atrophy with multiple injections of steroids into a small confined area, I'm not sure that atrophy of the Dupuytren's diseased tissue would be a bad thing.
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04/19/2007 01:31
Mark_D
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04/19/2007 01:31
Mark_D
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Re: Steroids
Bob:
Thanks for the helpful post.
Mark
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Dupuytrens Steroid article Steroids experience proliferation premenopausal reactivation injections criticized explanations dramatically treatment modulation Dupuytren discoloration triamcinolone pathogenesis necessitating programmed