This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (12) Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Badsha, H Articles by Chng, H H Search for Related Content PubMed PubMed Citation Articles by Badsha, H Articles by Chng, H H Social Bookmarking                   What's this?

Low-dose pulse methylprednisolone for systemic lupus erythematosus flares is efficacious and has a decreased risk of infectious complications

Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore 308433

K O Kong

T Y Lian

Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore 308433

S P Chan

Clinical Epidemiology Unit, Tan Tock Seng Hospital, Singapore 308433

C J Edwards

H H Chng

Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore 308433

We sought to test our clinical impression that using a low dose methylprednisolone pulse (MEP; µ1500 mg over 3 days) in treating flares of systemic lupus erythematosus (SLE) was effective and associated with fewer serious infections.

We retrospectively studied SLE patients who received MEP between 1989 and 2000. A ‘low dose’ group of 26 patients who had received 1–1.5 g and a ‘high dose’ group of 29 patients who received 3–5 g of MEP were identified. SLEDAI scores and prednisolone doses were recorded at the time of MEP pulses and 6 months later. All serious infections (requiring admission and i.v. antibiotics) occurring during this 6 month period and their outcomes were recorded.

Both groups had similar demographic data, initial SLEDAI scores, i.v. cyclophosphamide use, and SLE organ involvement. Despite high-and low-dose MEP being efficacious in controlling disease activity (lowering of SLEDAI scores and subsequent prednisolone dose) there were only nine episodes of serious infection in seven patients in the low-dose group compared with 20 episodes in 17 patients from the high-dose group (P ^ 0.04). In both groups a majority of infections (75 and 77% in the high-and low-dose groups) occurred in the first month after MEP. Those with a low serum albumin (< 20 g/l) had an increased risk of mortality (OR 44, 90% CI 6.19–312.98) and a trend towards greater numbers of infections.

Low-dose MEP was effective in controlling SLE flares and associated with fewer serious infections than traditional high-dose MEP.

Key Words: infection • lupus erythematosus, systemic • methylprednisolone • mortality • serum albumin

Lupus, Vol. 11, No. 8, 508-513 (2002)
DOI: 10.1191/0961203302lu243oa


CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				B. Parker and I. Bruce High dose methylprednisolone therapy for the treatment of severe systemic lupus erythematosus Lupus, June 1, 2007; 16(6): 387 - 393. [Abstract] [PDF]

				K O Kong, H Badsha, T Y Lian, C J Edwards, and H H Chng Letter to the Editor Lupus, March 1, 2004; 13(3): 212 - 213. [PDF]

				C J Edwards, T Y Lian, H Badsha, C L Teh, N Arden, and H H Chng Hospitalization of individuals with systemic lupus erythematosus: characteristics and predictors of outcome Lupus, September 1, 2003; 12(9): 672 - 676. [Abstract] [PDF]