NEW YORK (Reuters Health) – In children hospitalized with Henoch-Schönlein purpura, or HSP, corticosteroid treatment is associated with a decreased likelihood of several clinically relevant outcomes, according to findings reported in the October issue of Pediatrics.

Dr. Pamela F. Weiss with Children’s Hospital of Philadelphia and the University of Pennsylvania School of Medicine, and colleagues note that there is currently no agreement about the value of corticosteroids in HSP, despite it being the most common vasculitis in childhood.

To look into the issue, the investigators conducted a retrospective study of 1895 hospitalizations for HSP over an 8 year period, using information from the 36-hospital Pediatric Health Information System (PHIS) database. The median age of the cohort was 6 years, with 90% of them being 2 to 15 years old.

Oral or intravenous corticosteroid therapy was started in 42% of the children within 2 days of hospital admission, in 8% on days 3 or 4, and in 7% after day 4, according to the report.

“After multivariable regression modeling adjustment, early corticosteroid exposure significantly reduced the hazard ratios for abdominal surgery (0.39), endoscopy (0.27), and abdominal imaging (0.50) during hospitalization,” Dr. Weiss and colleagues report.

They believe that the findings warrant a prospective randomized controlled clinical trial. “If further studies confirm that corticosteroids are beneficial in the inpatient setting, then evidence-based practice guidelines could be established,” the team concludes.

Reference:

Corticosteroids May Improve Clinical Outcomes During Hospitalization for Henoch-Schönlein Purpura. Pediatrics 2010;126:674-681.