Liposteroid (dexamethasone palmitate), a lipid emulsion containing dexamethasone, was developed in Japan.

This agent poses greater efficacy and much less risk for systemic adverse effects than dexamethasone sodium phosphate, because the lipid emulsion is easily taken up by phagocytes, and retained in macrophages.

The article of liposteroid was firstly presented in 1982 (1).

Lliposteroid therapy has been used to treat rheumatoid arthritis in Japan.

Recently, Japanese researchers reported the clinical utility of liposteroid in the treatment of diseases associated with macrophage activation (2-6).

On the other hand, only the three countries outside of Japan currently have the marketing approval: Germany, Korea, and China.

I would like to know the efficacy and side effects of liposteroid therapy in various rheumatic diseases worldwide.

References

1. Mizushima Y, et al. Tissue distribution and anti-inflammatory activity of corticosteroids incorporated in lipid emulsion. Ann Rheum Dis. 1982;41:263-7.

2. Doi T, et al. Long-term liposteroid therapy for idiopathic pulmonary hemosiderosis. Eur J Pediatr. 2013;172:1475-81.

3. Nishiwaki S, et al. Dexamethasone palmitate ameliorates macrophages-rich graft-versus-host disease by inhibiting macrophage functions. PLoS One. 2014;9:e96252.

4. Wakiguchi H, et al. Successful control of juvenile dermatomyositis-associated macrophage activation syndrome and interstitial pneumonia: distinct kinetics of interleukin-6 and -18 levels. Pediatr Rheumatol. 2015;13:49.

5. Nakagishi Y, et al. Successful therapy of macrophage activation syndrome with dexamethasone palmitate. Mod Rheumatol. 2016;26:617-20.

6. Otsubo K, et al. Hemophagocytic lymphohistiocytosis caused by systemic herpes simplex virus type 1 infection: Successful treatment with dexamethasone palmitate. Pediatr Int. 2016;58:390-3.