Does corticosteroid therapy affect the survival of patients with systemic lupus erythematosus?

Albert, Daniel A.; Hadler, Nortin M.; Ropes, Marian W.

doi:10.1002/art.1780220901

Cited by 76 publications

(13 citation statements)

References 9 publications

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“…Serologically, old-age SLE also parallels procainamide-induced lupus in the infrequent occurrence of hypocomplementemia and antibody to native Recent studies of the natural history of SLE have consistently noted a more benign overall prognosis than that defined in classic descriptions of this disorder (20). Mortality rates, however, continue to be highest early in the course of the disease (2,21).…”

Section: (4)mentioning

confidence: 99%

Age influences the clinical and serologic expression of systemic lupus erythematosus

Wilso

Hamilton

Spyker

et al. 1981

Arthritis & Rheumatism

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The clinical and serologic characteristics of 17 patients with onset of systemic lupus erythematosus (SLE) after age 50 were compared with those of 49 younger patients. All patients were followed prospectively for a mean duration of 47 months. A clinical and serologic data base was established for each patient, and information collected at each visit to a lupus clinic was analyzed by computer. The clinical features distinguishing old-age SLE were a low incidence of significant renal disease and prominent pleuropericarditis and arthritis throughout the period of followup. Serologic abnormalities were milder in older patients. Thus, hypocomple-

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Section: (4)mentioning

confidence: 99%

Age influences the clinical and serologic expression of systemic lupus erythematosus

Wilso

Hamilton

Spyker

et al. 1981

Arthritis & Rheumatism

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“…Corticosteroid administration is an accepted mode of therapy in patients with SLE and active nephritis [1,7,14,21]. It is currently recommended that normalization of complement levels should be attempted in patients with lupus nephritis, since this has been associated with stabilization or improvement of renal function and morphology, while failure to do so has been followed by worsening of the renal disease [2, 3, 9, 131.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 1986

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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.

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“…Studies ma) use comparison or control groups that are concurrent (Le., subjects used specifically for the study) or historical (i.e., either patients treated before the beginning of the study or patient groups used in previously published studies [3,6]). The use of concurrent controls has several advantages, but it is also more costly, since a larger sample size is needed (7,8).…”

Section: Comparison Groupsmentioning

confidence: 99%

Clinical trials

Ratain

Hochberg²

1990

Arthritis & Rheumatism

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When new treatments for patients with rheumatic diseases become available, how are physicians to determine whether these therapies are efficacious? In initial trials of a drug or therapy, the treatment may be given to patients to determine its tolerability and safety; these studies will likely be open trials and will not use comparison or control groups of untreated or placebo-treated subjects. Subsequently, the therapy will need to be compared with either placebo and/or the standard therapy to determine its effectiveness. This type of clinical trial will involve the identification of appropriate comparison or control groups and the selection of valid study design. In this article, we will review 1) the types of comparison groups that can be used to assess the effectiveness of a treatment; 2) elements in the design of prospective, controlled clinical trials, including concerns regarding comparability of the treatment groups and generalizability of the study results to different patient populations; 3) differences between parallel and crossover trials; 4) current concepts of outcome measures; and 5 ) issues regarding the statistical analyses used in these trials, including inferences based on significance testing. The reader is also referred to other reviews (1,2) that have addressed similar issues in relation to rheumatic disease.

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Does corticosteroid therapy affect the survival of patients with systemic lupus erythematosus?

Cited by 76 publications

References 9 publications

Age influences the clinical and serologic expression of systemic lupus erythematosus

Age influences the clinical and serologic expression of systemic lupus erythematosus

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

Clinical trials

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