[Improvement of the maintenance therapy after methylprednisolone pulse therapy--effect of prednisolone combined with immunosuppressants].
OBJECTIVE
We investigated the effect of the combination therapy of prednisolone (PSL) and immunosuppressants after methylprednisolone pulse therapy.


METHODS
A protocol of PSL (15-20 mg/day) and mizoribine (150-200 mg/day) after methylprednisolone (mPSL) pulses was used for 2 years to treat 7 patients (PSL + MZB group). Cyclophosphamide (CYC) pulse therapy was added to the combined therapy in 4 patients with severe lupus nephritis. The total dose of predinisolone, and side effects were compared with those in 6 patients who were treated with PSL (30 mg/kg) alone after mPSL pulse therapy (PSL group).


RESULTS
No relapses occurred in the PSL + MZB group, although all of 6 patients relapsed in the PSL Group. The total doses of PSL in the PSL + MZB group was about 70% of the PSL Group. There were two patients with Herpes-Zoster infection and one patient with liver dysfunction as side effects, with no differences in the frequency of side effects between the was groups.


CONCLUSIONS
Combination maintenance therapy with prednisolone and immunosuppressants after methylprednisolone pulse therapy was effective in preventing relapse.
Miyamae
T
T
Department of Pediatrics, Yokohama City University School of Medicine.
Nakasima
S
S
Imagawa
T
T
Ito
S
S
Katakura
S
S
Tomono
N
N
Mori
M
M
Ibe
M
M
Mitsuda
T
T
Aihara
Y
Y
Yokota
S
S
D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002648:Child; D003520:Cyclophosphamide / Q000008:administration & dosage* / Q000009:adverse effects; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D008181:Lupus Nephritis / Q000188:drug therapy* / Q000517:prevention & control; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage* / Q000009:adverse effects; D011239:Prednisolone / Q000008:administration & dosage / Q000009:adverse effects; D020551:Pulse Therapy, Drug; D012074:Remission Induction; D012263:Ribonucleosides / Q000008:administration & dosage* / Q000009:adverse effects; D055502:Secondary Prevention
D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D012263:Ribonucleosides; C010052:mizoribine; D003520:Cyclophosphamide; D011239:Prednisolone; D008775:Methylprednisolone