Hi Megan,

I am sure you and I are talking about the same article by Punthakee, et. al.  You are right that it refers specifically to prednisolone, but from what I understand, prednisone and prednisolone are considered to be of the same potency.  The biggest difference between them is their plasma half-life, or the rate at which the medication is eliminated from the bloodstream.  So, like you, I also presume that when considering only potency, similar conclusions can probably be drawn about prednisone, as were drawn about prednisolone in the Canadian study (if everything else remains the same.) 

Yes, I suppose that is part of the reason why we need the type of studies that Jenny has mentioned.  After having read a number of them, though (as I’m sure have you) I have to admit that I have found most of them very dissatisfying.  It is not really the fault of the researchers, per se, but that there are so many variables to consider.  How can one be sure that when even only one variable is changed, that the results and conclusions will not change, as well? 

For example, I know the present study is to compare hydrocortisone vs. prednisone vs. dexamethasone.  But, what exactly are they talking about?  One dose of each, given at exactly the same time each day?  Or three equal doses of hc given at 8 hour intervals vs. 2 equal doses of prednisone given at 12 hour intervals vs. one dose of dex given once in the morning.  But, what if they changed that one dose of dex to being given at night? 

And what if they only gave two doses of hydrocortisone?  What if they gave four doses of hydrocortisone?  And what if they varied the amounts and times that those doses were given?  What if they did the same thing with prednisone and dexamethasone?  The permutations are endless (as would probably be the results and conclusions!)

In that way, I really do hope that---in order to be truly worthwhile, and not just hash over the same old stuff---that this new study is thoughtfully designed and tries to level the playing field (betweeen the different meds) as much as possible, right from the start.