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Topic Suggestion Description

Date submitted: October 14, 2012

Briefly describe a specific question, or set of related questions, about a health care test or treatment that this program should consider.
safety and efficacy of deflazacort in comparison with that of prednisolone in systemic autoimmune rheumatic diseases
Does your question include a comparison of different health care approaches? (If no, your topic will still be considered.)
yes
If yes, explain the specific technologies, devices, drugs, or interventions you would like to see compared:
deflazacort versus prednisolone in prevention of cushingoid toxicities
What patients or group(s) of patients does your question apply to? (Please include specific details such as age range, gender, coexisting diagnoses, and indications for therapy.)
female patients between 20 and 40 with a diagnosis of lupus with lupus nephritis
Are there subgroups of patients that your question might apply to? (For example, an ethnic group, stage or severity of a disease.)
Asian south India paatients, WHO class 3 and 4 lupus nephritis
Describe the health-related benefits you are interested in. (For example, improvements in patient symptoms or problems from treatment or diagnosis.)
improvement in renal SLEDAI score and quality of life
Describe any health-related risks, side effects, or harms that you are concerned about.
cushingoid and related toxicity

Appropriateness for EHC Program

Does your question include a health care drug, intervention, device, or technology available (or likely to be available) in the U.S.?
Which priority area(s) and population(s) does this topic apply to? (check all that apply)
EHC Priority Conditions (updated in 2008)
  • Arthritis and nontraumatic joint disorders
AHRQ Priority Populations
  • Low income groups
  • Women
Federal Health Care Program
  • Other

Importance

Describe why this topic is important.
Deflazacort is a molecule related to prednisolone; although it is costly, its cost has come down in developing nations due to generic preparations. It is widely used in India. There is paucity of data on this drug related trials. we have experience with thousands of patients and clearly notice much less weight gain and cushingoid appearance, lesser glucose impairment and lesser osteoporosis. We want prove these points one by one. actually , cost may be cheaper and efficacy is similar.
What specifically motivated you to ask this question? (For example, you are developing a clinical guideline, working with a policy with large uncertainty about the appropriate approach, costly intervention, new research you have read, items in the media you may have seen, a clinical practice dilemma you know of, etc.)
same as mentioned in the preceding para
Does your question represent uncertainty for clinicians and/or policy-makers? (For example, variations in clinical care, controversy in what constitutes appropriate clinical care, or a policy decision.)
yes
If yes, please explain:
we need to generate this evidence which will be helpful for all rheumatologists

Potential Impact

How will an answer to your research question be used or help inform decisions for you or your group?
It will go a long way, as it will change practice especially due to lesser side effects
Describe the timeframe in which an answer to your question is needed.
at the earliest
Describe any health disparities, inequities, or impact on vulnerable populations your question applies to.
majority of population can afford in India; those cant afford- for them, govt may bringdown cost, if this evidence is generated

Nominator Information

Other Information About You: (optional)
Please choose a description that best describes your role or perspective: (you may select more than one category if appropriate)
  • Physician
Are you making a suggestion as an individual or on behalf of an organization?
Individual
Please tell us how you heard about the Effective Health Care Program
from published literature, web