to carol
5/5/00 0:04 AM
I located one article. This one has more to do with mg/m2 than with staying a little on the lower side of doses. I'll keep looking for that one. We just moved and wow what a mess. The article that references mg/m2 is from the New England Journal of Medicine, Dec 27, 1990. I guess it is 10 years old now - not sure if any of the research has changed. The article talks about experimental use of reduced doses of hydrocortisone and the use of the antiandrogen flutamide and an inhibitor of androgen-to- estrogen conversion. (I think this is like what the current NIH study is doing). We don't have a fax or scanner so it is a bit difficult at this time to get the article to you, but I will type in a bit and hope you can find the whole article on the internet or in the library. The part I am typing just gave me an idea of what the mg/m2 was typically in mild to severe cases. I'll keep looking for the other article. "Glucocorticoid replacement is usually accomplished with oral hydrocortisone. The dose of hydrocortisone should be the lowest that will slow growth velocity and the rate of skeletal maturation to normal. In patients with milder defects in 21 hydroxylase activity, satisfactory control can sometimes be achieved with physiologic doses of 12-15 mg of hydrocortisone per square meter of body surface area per day. Patients with more severe defects, however, often require supraphysiologic doses (e.g. 25mg of hydrocortisone per square meter per day) for satisfactory control. " Hope that helps.
Chris D
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