
In Lupus, Start Low, Stay Low with Steroids | Medpage Today
ArrayPatiënten met #lupus die aanvankelijk werden ingesteld met een gemiddelde of hoge doses prednison blijven langer op die hogere doses. Hierdoor lopen ze waarschijnlijk een verhoogd risico op de behandeling gerelateerde complicaties, aldus de Spaanse onderzoekers Guillermo Ruiz-Irastorza, MD, van het Hospital Universitario Cruces in Barakaldo, en collega’s.
Bij patiënten die prednison medium doseringen van 7,5 tot 30 mg / dag gedurende de eerste maand van de behandeling kregen. Hadden een grotere kans verder op in het behandeltraject om doseringen boven 7,5 mg / dag gedurende het eerste jaar en zelfs 8 maal hoger (OR 8.4, 95% CI 3,7 tot 18,8), vergeleken met patiënten zonder prednison.
In Lupus, Start Low, Stay Low with Steroids | Medpage
Today”Glucocorticoids constitute one of the main therapies for systemic lupus erythematosus. However, despite their proven efficacy, oral glucocorticoids are important predictors of irreversible damage in lupus,” the researchers wrote.
In contrast, patients given low doses for the first month — below 7.5 mg/day — were unlikely to be on medium or high doses later in the year (OR 1.4, 95% CI 0.87 to 4.7).
And for those starting treatment on high dosages — above 30 mg/day — the odds of remaining on dosages above 7.5 mg/day were even higher (OR 21.2, 95% CI 9.8 to 52.6), the researchers reported online in LUPUS Science & Medicine.
Among patients given prednisone in medium dosages of 7.5 to 30 mg/day during their first month of treatment, the likelihood of continuing on dosages above 7.5 mg/day throughout the first year was 8-fold higher (OR 8.4, 95% CI 3.7 to 18.8) compared with patients not on prednisone, according to the study by Guillermo Ruiz-Irastorza, MD, of Hospital Universitario Cruces in Barakaldo, and colleagues.
Patients with lupus who were initially treated with medium or high doses of prednisone were likely to continue on higher doses, potentially putting them at risk for treatment-related complications, Spanish researchers reported.