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Intravenous pulse methylprednisolone in severe systemic lupus erythematosus

Objectives: To evaluate the effective and the safety of pulse methylprednisolone (MP) in severe systemic lupus erythematosus (SLE) flares. Subjects and methods: An interventive and comparative study was carried out on 80 patients with SLE flares. | JOURNAL OF MILITARY PHARMACO-MEDICINE N09-2017 INTRAVENOUS PULSE METHYLPREDNISOLONE IN SEVERE SYSTEMIC LUPUS ERYTHEMATOSUS Huynh Van Khoa*; Le Anh Thu*; Le Thu Ha** SUMMARY Objectives: To evaluate the effective and the safety of pulse methylprednisolone (MP) in severe systemic lupus erythematosus (SLE) flares. Subjects and methods: An interventive and comparative study was carried out on 80 patients with SLE flares. Results: We followed 80 patients with severe lupus flare who were treated with pulse MP in 12 weeks. The patients were assessed before the treatment (T0), 1 week after the treatment (T1), 4 weeks after the treatment (T2) and 12 weeks after the treatment (T3). The anti-dsDNA titer significantly decreased after the treatment (163.91 ± 92.67 at T0, 82.90 ± 75.61 at T1, 54.22 ± 50.66 at T2 and 35.88 ± 27.68 at T3. The SLEDAI score also significantly improved with the mean decrease (23.33 at T0, 14.03 at T1, 8.63 at T2 and 6.85 at T3). The rate of patients with SLEDAI above 20 decreased after the treatment (65% at T0, 11.3% at T1, 1.3% at T2, and 0% at T3). As for 47 patients with nephrotic syndrome, at T1, no patients had complete response rate, partial response were seen in 31.9% and no response 68.1%, at T2, 6.4%; 51.1% and 42.6%, respectively, at T3, 19.1%; 70.2% and 10.6%, respectively. The infection was seen in 12.5% of those patients, mostly in the first week after the pulse MP. Conclusion: Pulse MP seemed to be effective in the SLE patients on severe flares. The most common adverse effect of this therapy is the infection, especially in the first week after the pulse. * Keywords: Severe systemic lupus erythematosus; Nephrotic syndrome; Pulse therapy. INTRODUCTION Lupus is a systemic autoimmune disease that occurs when your body's immune system attacks tissues and organs. Inflammation caused by lupus can affect many different body systems, including joints, skin, kidneys, blood cells, brain, heart and lungs. Lupus can be difficult to diagnose because