Pulsed methylprednisolone therapy compared to high dose prednisone in systemic lupus erythematosus nephritis

This study was done to determine whether intravenous methylprednisolone therapy given concomitantly with low-dose daily, oral prednisone would be as effective as high-dose daily prednisone in the treatment of patients with active systemic lupus erythematosus (SLE) nephritis. Thirteen patients with a...

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Bibliographic Details
Published in:European journal of pediatrics 1986-10, Vol.145 (5), p.380-383
Main Authors: GARIN, E. H, SLEASMAN, J. W, RICHARD, G. A, IRAVANI, A. A, FENNELL, R. S
Format: Article
Language:English
Subjects:
Adolescent
Adult
Biological and medical sciences
Blood Pressure - drug effects
Child
Complement C3 - analysis
Complement C4 - analysis
Creatinine - blood
Drug Administration Schedule
Drug Therapy, Combination
Female
Humans
Lupus Nephritis - drug therapy
Lupus Nephritis - physiopathology
Male
Medical sciences
Methylprednisolone - administration & dosage
Methylprednisolone - adverse effects
Pharmacology. Drug treatments
Prednisone - administration & dosage
Prednisone - adverse effects
Skin, nail, hair, dermoskeleton
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Summary:This study was done to determine whether intravenous methylprednisolone therapy given concomitantly with low-dose daily, oral prednisone would be as effective as high-dose daily prednisone in the treatment of patients with active systemic lupus erythematosus (SLE) nephritis. Thirteen patients with active SLE nephritis were started on 2 mg/kg prednisone per day, considered the high prednisone phase. Therapy was continued until remission was achieved. Prednisone administration was then tapered to less than 0.5 but more than 0.2 mg/kg per day. On later relapse, these patients received three doses of methylprednisolone (20 mg/kg per dose) on alternate days and continued on the same daily dose of prednisone (less than 0.5 greater than 0.2 mg/kg per day) prior to pulse therapy; this was the methylprednisolone phase. The 13 patients were studied in both phases, serving as their own controls. After 1 month of therapy, no significant differences were observed between treatment phases as to improvement in clinical and laboratory findings. A significant increase in the serum concentration of C3 and C4 was seen both in the high-dose prednisone and methylprednisolone phases, while the serum concentration of anti-ds DNA antibody significantly decreased. Methylprednisolone therapy seems as effective as high-dose prednisone in patients with relapse of SLE nephritis. Because side effects are minimal, methylprednisolone administration may be tried as the therapy of choice for these patients.
ISSN:0340-6199
1432-1076
DOI:10.1007/BF00439243