Background:
Corticosteroids are commonly used in the treatment of Duchenne muscular dystrophy [DMD], with research demonstrating improved strength and slowed disease progression in those taking corticosteroids compared to those who do not. However, the use of corticosteroids has been associated with adverse effects on mental health. There is minimal evidence regarding whether the age at which patients start taking corticosteroids is associated with quality-of-life outcomes and depressive symptoms.
Objective:
The objective of the present study was to investigate whether the age at which patients start taking corticosteroids is associated with Pediatric Quality of Life Inventory for DMD (PedsQL-DMD) and the Children’s Depression Inventory-2nd Edition (CDI-2) scores.
Results:
Twenty-five of the 36 total patients received corticosteroid therapy. The average age of those those taking corticosteroids was 15.4 years old with an average age of initiation of 6.8 years old. Fourteen patients started corticosteroid therapy when over 5 years old, 7 patients started at 5 years old or younger, and 4 patients’ ages at the time of initiating therapy were unknown. The average age of patients not taking corticosteroids was 17.8 years. Quality of life scores were similar between groups in all domains except worry, in which patients who began corticosteroids at or younger than 5 years old reported lower levels of worry than those who started at ages older than 5 years (p=0.04). Regarding depressive symptoms, patients who started corticosteroid therapy when older than 5 years reported lower CDI-2 scores than those who started at or before 5 years (p=0.04) and those who did not receive corticosteroid therapy (p=0.04).
Conclusions:
Though treatment with corticosteroids is common in patients with DMD, the age at which patients are started on this therapy varies. The age at which patients are started on this treatment may be associated with mental health outcomes later in life.