Prednisolone in the treatment of adrenal insufficiency: a re-evaluation of relative potency

Prednisolone has unknown growth-suppressing effects relative to other steroids. We retrospectively studied 9 children (6 with congenital adrenal hyperplasia, CAH) receiving hydrocortisone replacement after switching to prednisolone (dose ratio, 1:5). Growth velocity and, in patients with CAH, 17-OHP decreased significantly. Dose reduction reversed these effects. Roughly, growth suppression relative potency for prednisolone:hydrocortisone was 15:1.