Treatment of systemic lupus erythematosus with dehydroepiandrosterone: 50 patients treated up to 12 months.
OBJECTIVE
To determine whether longterm therapy (up to 1 year) with the weakly androgenic adrenal steroid dehydroepiandrosterone (DHEA) is feasible and beneficial in patients with mild to moderate systemic lupus erythematosus (SLE).


METHODS
In a prospective, open label, uncontrolled longitudinal study 50 female patients (37 premenopausal, 13 postmenopausal) with mild to moderate SLE were treated with oral DHEA 50-200 mg/day.


RESULTS
DHEA therapy was associated with increases in the serum levels of DHEA, DHEA sulfate, and testosterone and, for those patients who continued DHEA, with decreasing disease activity measured by SLE Disease Activity Index score (p < 0.01), patient global assessment (p < 0.01), and physician global assessment (p < 0.05), compared to baseline. Concurrent prednisone doses were reduced (p < 0.05). These improvements were sustained over the entire treatment period. Thirty-four patients (68%) completed 6 months of treatment and 21 patients (42%) completed 12 months. Mild acneiform dermatitis was the most common adverse event (54%). Pre and postmenopausal women experienced similar efficacy and adverse effects from DHEA.


CONCLUSIONS
DHEA was well tolerated and appeared clinically beneficial, with the benefits sustained for at least one year in those patients who maintained therapy.
van Vollenhoven
R F
RF
Division of Immunology and Rheumatology, Stanford University Medical Center, CA 94305-5111, USA.
Morabito
L M
LM
Engleman
E G
EG
McGuire
J L
JL
D000328:Adult; D003687:Dehydroepiandrosterone / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy*; D008875:Middle Aged; D017698:Postmenopause; D011241:Prednisone / Q000008:administration & dosage; D017697:Premenopause; D011446:Prospective Studies; D013739:Testosterone / Q000097:blood; D013997:Time Factors; D016896:Treatment Outcome
D013739:Testosterone; D003687:Dehydroepiandrosterone; D019314:Dehydroepiandrosterone Sulfate; D011241:Prednisone