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

Journal Article

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.

Full Text

Duke Authors

Cited Authors

  • Garin, EH; Sleasman, JW; Richard, GA; Iravani, AA; Fennell, RS

Published Date

  • October 1, 1986

Published In

Volume / Issue

  • 145 / 5

Start / End Page

  • 380 - 383

PubMed ID

  • 3792382

Electronic International Standard Serial Number (EISSN)

  • 1432-1076

International Standard Serial Number (ISSN)

  • 0340-6199

Digital Object Identifier (DOI)

  • 10.1007/bf00439243

Language

  • eng