"We saw that by the end of the fourth year most of them, 80%, had been treated with prednisone at some point, and by the fifth year nearly 4 out of every 10, 37.8%, had developed damage," pointed out Dr Ruiz-Iraztorza. Significantly, the patients with damage had received higher doses of prednisone (10.4 mg/day as opposed to 6 mg/day in the patients without damage). In the specific study of the damage that could be directly attributed to the use of glucocorticoids, the results were similar, with average daily doses of 11 vs. 7 mg/day, respectively. And it does not stop there. As previous studies had suggested, they proved that the association with damage began with average doses of 7.5 mg/day. "In other words, above that dose, permanent side effects may appear." By contrast, pulsed methylprednisolone therapy was not associated with any kind of damage.
Anti-malarial drugs for treating lupus
The research carried out by the group at the Hospital Universitario Cruces has been published in the specialised journal Rheumatology. In fact, these results have confirmed that the guidelines used in the Auto-immune Disease unit of the Hospital Universitario Cruces for several years are good. Dr Ruiz-Irastorza stresses that the background treatment in patients with SLE has to be anti-malarial drugs, specifically hydroxychloroquine, since, as he maintains, "it has been proven that they are more effective in the long term than glucocorticoids for controlling lupus and, at the same time, they have far fewer side effects. The role of the latter needs to be restricted to managing periods during which the disease flares up."
"The beneficial effect of anti-malarial drugs on SLE was discovered by accident during the Second World War," explained the doctor. "In any case, as prolonged background treatment they were seen to be ideal for controlling
|Contact: Matxalen Sotillo|
University of the Basque Country