Ist die Steroidpulstherapie der konventionellen Hochdosissteroidtherapie überlegen?

Zusammenfassung

Seit die Steroidpulstherapie vor ca. 50 Jahren als besondere Applikationsform von Glukokortikoiden eingeführt wurde, konnte sie in vielen Bereichen der Kinder- und Jugendmedizin mit teilweise großem Erfolg eingesetzt werden. Offenbar kommen andere Wirkmechanismen zur genomischen Wirkung der Glukokortikoide noch hinzu. Trotz der hohen Steroiddosis ist die Verträglichkeit vor allem bei Kindern überwiegend sehr gut. Da sie im Intervall von ca. 2–4 Wochen an je 3–5 Tagen durchgeführt wird, ist insbesondere die von Jugendlichen gefürchtete cushingoide Fazies weitgehend zu vermeiden. Direkte vergleichende Studien zur konventionellen oralen Steroidmedikation sind sehr selten; die überwiegende Zahl an Publikationen zur Steroidpulstherapie bezieht sich auf deren Indikation und Effektivität. Auch im Zeitalter der Biologika bleibt die Steroidpulstherapie ein wesentlicher Baustein einer antientzündlichen Therapie.

Abstract

Since steroid pulse therapy was introduced approximately 50 years ago as a special form of glucocorticoid administration, it has been used with great success in many areas of pediatric and adolescent medicine. Apparently, other mechanisms of action are added to the genomic effect of glucocorticoids. Despite the high steroid dose, tolerability is generally very good, especially in children. Since it is administered at intervals of approximately 2–4 weeks for 3–5 days at a time, the cushingoid facies feared by adolescents in particular can be largely avoided. Direct comparative studies with conventional oral steroid medication are very rare; the vast majority of publications on steroid pulse therapy refer to its indications and effectiveness. Even in the age of biologics, steroid pulse therapy remains an essential component of anti-inflammatory therapy.

Schlüsselwörter

Steroidpulstherapie - unerwünschte Effekte - Glukokortikoid-Therapie

Keywords

steroid pulse therapy - adverse effects - glucocorticoid therapy

Publikationsverlauf

Artikel online veröffentlicht:
04. Dezember 2025

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