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Prednisolone failed to increase viremia in dengue
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Prednisolone therapy in the early stages of dengue infection was not associated with any adverse effects or delayed viral clearance, according to researchers from the Hospital for Tropical Diseases in Ho Chi Minh City, Vietnam.
“Because dengue shock syndrome occurs around the fifth day of illness, intervention with steroids early in infection may prevent or ameliorate the severity of this serious complication,” the researchers wrote in Clinical Infectious Diseases. “However, before considering a large-scale efficacy trial, we wished to assess whether immunomodulation during the viremic phase interferes with viral clearance mechanisms.”
The researchers performed a randomized, placebo-controlled, partially masked trial among 225 patients aged 5 to 20 years who had suspected dengue. The participants were randomly assigned to a low-dose regimen (0.5 mg/kg) of oral prednisolone, a high-dose regimen (2 mg/kg) or placebo. They received the treatment once daily for 3 days.
The participants had similar baseline characteristics. All patients fully recovered, and the researchers found no associations between treatment and the development of dengue shock syndrome, need for ICU admission, clinical bleeding, hyperglycemia, platelet nadir, maximum hematocrit and adverse events. They also found no effect on viremia or hematological parameters.
“As the global burden of dengue increases, there is great interest in developing novel therapeutic strategies to improve outcome, focused on agents that target the virus and/or the immune response,” the researchers wrote. “This and other recent intervention studies suggest that any potential therapy will likely need to be initiated very early in the disease evolution.”
Disclosure: One of the study researchers is a consultant for Unither Virology LLC.
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