The University of Southampton
University of Southampton Institutional Repository

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

Low-dose pulse methylprednisolone for systemic lupus erythematosus flares is efficacious and has a decreased risk of infectious complications
Low-dose pulse methylprednisolone for systemic lupus erythematosus flares is efficacious and has a decreased risk of infectious complications
We sought to test our clinical impression that using a low dose methylprednisolone pulse (MEP; 1500mg 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 1-1.5g and a 'high dose' group of 29 patients who received 3-5g 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 (<20g/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.
infection, lupus erythematosus, systemic, methylprednisolone, mortality, serum albumin
508-513
Badsha, H.
c68de22c-961c-42f3-8795-48de207c6695
Kong, K.O.
b6a371c4-7c82-4002-a20c-971dbf478c3f
Lian, T.Y.
c0605237-001f-43b5-929e-e895b96311fd
Chan, S.P.
83efdf11-1cbf-4f4e-97c6-854c5a80f6d6
Edwards, C.J.
dcb27fec-75ea-4575-a844-3588bcf14106
Chng, H.H.
09ae46f9-8c9b-4334-84b1-787f80db7f22
Badsha, H.
c68de22c-961c-42f3-8795-48de207c6695
Kong, K.O.
b6a371c4-7c82-4002-a20c-971dbf478c3f
Lian, T.Y.
c0605237-001f-43b5-929e-e895b96311fd
Chan, S.P.
83efdf11-1cbf-4f4e-97c6-854c5a80f6d6
Edwards, C.J.
dcb27fec-75ea-4575-a844-3588bcf14106
Chng, H.H.
09ae46f9-8c9b-4334-84b1-787f80db7f22

Badsha, H., Kong, K.O., Lian, T.Y., Chan, S.P., Edwards, C.J. and Chng, H.H. (2002) Low-dose pulse methylprednisolone for systemic lupus erythematosus flares is efficacious and has a decreased risk of infectious complications. Lupus, 11 (8), 508-513.

Record type: Article

Abstract

We sought to test our clinical impression that using a low dose methylprednisolone pulse (MEP; 1500mg 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 1-1.5g and a 'high dose' group of 29 patients who received 3-5g 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 (<20g/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.

This record has no associated files available for download.

More information

Published date: 2002
Keywords: infection, lupus erythematosus, systemic, methylprednisolone, mortality, serum albumin

Identifiers

Local EPrints ID: 25210
URI: http://eprints.soton.ac.uk/id/eprint/25210
PURE UUID: 11bb44c3-7c95-4441-935e-46b029a9b665

Catalogue record

Date deposited: 07 Apr 2006
Last modified: 08 Jan 2022 18:53

Export record

Contributors

Author: H. Badsha
Author: K.O. Kong
Author: T.Y. Lian
Author: S.P. Chan
Author: C.J. Edwards
Author: H.H. Chng

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×