Le solupred - c'est ce que l'on appelle la corticothérapie générale. Le traitement que l'on vous propose est un traitement de court terme - sont effet est en général rapidement positif sur la pelade mais la rechute est le plus souvent tout aussi rapide- les effets secondaires d'une corticothérapie générale courte sont très modérés en l'absence de contre-indication. Ce traitement n'est plus guère donné car il faut souvent maintenir des doses éleves supérieures à 30mg par jour pour conserver les résultats, malheureusement à ces doses- les effets secondaires sont rapidement problématiques.


Vous pouvez lire ce texte intéressant si vous parlez l'anglais - [URL="http://www.keratin.com/ad/ad047.shtml"]Corticothérapie générale pour le traitement de la pelade[/URL] - [URL="http://www.keratin.com/ad/ad047.shtml"][FONT=Arial]Systemic corticosteroids for alopecia areata[/FONT][/URL]

Auteur Dr Kevin Mc Elvee

"Success rate of systemic corticosteroids in alopecia areata treatment The first therapeutic experiments in alopecia areata with orally administered cortisone areata were carried out on 22 patients (4 with alopecia totalis, 11 with alopecia universalis, and 7 with patchy hair loss). These patients were treated with cortisone acetate tablets in tapered dosage. Sixteen of the 22 patients re-grew hair, with the onset of re-growth within 3 to 6 weeks. Conclusions drawn were that persons having a longer duration of the last episode of alopecia areata and those having a history of active disease during adolescence were associated with failure to respond to oral cortisone acetate. Discontinuing therapy or decreasing the dose below desirable levels was associated with a relapse.

Several authors have performed pulse administration of corticosteroids in single doses, in an effort to reduce the side effects of the steroids to an acceptable level and produce prolonged hair re growth. Pulse therapy involves short, intensive administration of pharmacotherapy, usually given at intervals such as weekly or monthly. Results of the studies show that major side effects were not observed in pulsed administration of corticosteroids in alopecia areata patients. Side effects that have been documented include nausea, flush, headache, fatigue, palpitations, dyspnea (shortness of breath) and giddiness. However, variable results with pulse therapy have been observed in different sets of case studies.
Many trials have been conducted to confirm the effects of oral prednisone on alopecia areata. Although the initial re-growth appears promising, the prednisone dose necessary to maintain cosmetic growth is usually too high and adverse effects are inevitable. An initial benefit may occur by using systemic prednisone in some patients, but the relapse rate is high, and it does not appear to alter the course of the condition. Systemic prednisone is, therefore, not an agent of choice for alopecia areata because of the adverse effects associated with both short-term and long-term treatment.
The use of intramuscular steroids has also been evaluated by many authors in the treatment of alopecia areata. In such form of treatment, the drug is administered by intravenous (IV) or intramuscular injection, and it works by blocking certain subsets of activated T cells. The side effects of intramuscular steroids are the same as those observed with the prolonged use of oral steroids.
Because of the associated unfavorable side effects, there is a need to get patients off systemic steroid use as soon as possible, and this form of treatment needs to be used in conjunction with other treatment modules to help sustain the re-growth when systemic steroid treatment is stopped. For this reason, some medical professionals advocate the benefits of combination therapy with topical, intralesional, and oral corticosteroids for alopecia areata patients.
Results of research studies conducted indicate that systemic steroid administration is a module of alopecia areata therapy for which partial success has been claimed. In fact, the steroids only succeed in promoting a temporary re-growth of hair and subsequent relapse when the treatment is stopped. All in all, there is no strong evidence to suggest that systemic drug-induced remissions or therapies alter the course of alopecia areata, and it is increasingly clear that the available treatment options at best manage to suppress the underlying process. "


Résumé - Dr Abimelec

De nombreux éssais thérapeutiques confirment l'effet positif de la cortisone par voie générale dans le traitement de la pelade. Bien que la repousse initiale soit en général prometeuse, les doses qui sont nécessaire pour maintenir le résultat sont en général trop élevées de telle manière que la survenue d'effets secondaires sérieux est alors inévitable. On observe parfois un bénéfice chez certains patients mais le taux de rechute est important.


Commentaires

Malgré les résultats en général décevants, ce traitement est prescrit dans des circonstances particulières - lorsqu'une chute très importante précède de quelques semaines un évènement marquant comme un mariage par ex… Dans certains cas, la repousse se maintient plusieurs mois , mais ce n'est pas la règle.