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ADT is a corticosteroid dosing regimen in which twice the usual daily dose of corticoid is administered every other morningThe purpose of this mode of therapy is to provide the patient requiring long-term pharmacologic dose treatment with the beneficial effects of corticoids while minimizing certain undesirable effectsincluding pituitary-adrenal suppressionthe Cushingoid statecorticoid withdrawal symptomsand growth suppression in children.

The rationale for this treatment schedule is based on two major premisesathe anti-inflammatory or therapeutic effect of corticoids persists longer than their physical presence and metabolic effects andbadministration of the corticosteroid every other morning allows for re-establishment of more nearly normal hypothalamic-pituitary-adrenalHPAactivity on the off-steroid day.

5As indicated abovecertain corticosteroidsbecause of their prolonged suppressive effect on adrenal activityare not recommended for alternate day therapyegdexamethasone and betamethasone

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Some side effects may require medical attentionOther side effects do not require medical attention and may go away during treatmentPatients should check with their physician about any side effects that continue or are bothersome.

The adverse effects of corticosteroids in pediatric patients are similar to those in adultssee ADVERSE REACTIONSLike adultspediatric patients should be carefully observed with frequent measurements of blood pressureweightheightintraocular pressureand clinical evaluation for the presence of infectionpsychosocial disturbancesthromboembolismpeptic ulcerscataractsand osteoporosisPediatric patients who are treated with corticosteroids by any routeincluding systemically administered corticosteroidsmay experience a decrease in their growth velocityThis negative impact of corticosteroids on growth has been observed at low systemic doses and in the absence of laboratory evidence of hypothalamic-pituitary-adrenalHPAaxis suppressioni.ecosyntropin stimulation and basal cortisol plasma levelsGrowth velocity may therefore be a more sensitive indicator of systemic corticosteroid exposure in pediatric patients than some commonly used tests of HPA axis functionThe linear growth of pediatric patients treated with corticosteroids should be monitoredand the potential growth effects of prolonged treatment should be weighed against clinical benefits obtained and the availability of treatment alternativesIn order to minimize the potential growth effects of corticosteroidspediatric patients should be titrated to the lowest effective dose.

Since complications of treatment with corticosteroids are dependent on the size of the dose and the duration of treatmenta risk/benefit decision must be made in each individual case as to dose and duration of treatment and as to whether daily or intermittent therapy should be used.

Use lowest possible dose to control condition under treatmentrisk/benefit decision must be made in each individual case as to dose and duration of treatment and as to whether daily or intermittent therapy should be used.

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Choosing to participate in a study is an important personal decisionTalk with your doctor and family members or friends about deciding to join a studyTo learn more about this studyyou or your doctor may contact the study research staff using the contacts provided belowFor general informationLearn About Clinical Studies.

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