Effects of prasterone on bone mineral density in women with systemic lupus erythematosus receiving chronic glucocorticoid therapy.
OBJECTIVE
To assess the effects of treatment with prasterone (dehydroepiandrosterone) on bone mineral density (BMD) in female patients with mild to moderate systemic lupus erythematosus (SLE) receiving chronic treatment with glucocorticoids.


METHODS
Fifty-five female patients with SLE who had received prednisone (or glucocorticoid equivalent) </= 10 mg/day for >/= 6 months were treated for 1 year with either prasterone 200 mg/day (n = 24) or placebo (n = 31) in this randomized, double blind trial. Prasterone or placebo was added to each patient's one or more concomitant standard SLE medications, including glucocorticoids, nonsteroidal antiinflammatory drugs, antimalarials, methotrexate, azathioprine, and other immunosuppressives, which were to be maintained at fixed doses for the duration of the study.


RESULTS
BMD was significantly improved in patients who received prasterone compared to placebo. At the lumbar spine, there was a mean (SEM) gain in BMD of 1.7 +/- 0.8% in the prasterone group compared to a mean loss in BMD of -1.1 +/- 0.5% in the placebo group (p = 0.003 between groups). For the total hip, mean gain was 2.0 +/- 0.9% in the prasterone group vs a mean loss of -0.3 +/- 0.4% in the placebo group (p = 0.013 between groups). In the prasterone treatment group, the mean gains from baseline at both lumbar spine and hip were statistically significant.


CONCLUSIONS
Prasterone treatment prevented BMD loss and significantly increased BMD at both the lumbar spine and total hip in female patients with SLE receiving exogenous glucocorticoids.
Mease
Philip J
PJ
Seattle Rheumatology Associates, Seattle, Washington, USA.
Ginzler
Ellen M
EM
Gluck
Oscar S
OS
Schiff
Michael
M
Goldman
Allan
A
Greenwald
Maria
M
Cohen
Stanley
S
Egan
Rita
R
Quarles
Betty J
BJ
Schwartz
Kenneth E
KE
D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000328:Adult; D015519:Bone Density / Q000187:drug effects*; D003687:Dehydroepiandrosterone / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use*; D016896:Treatment Outcome
D000276:Adjuvants, Immunologic; D005938:Glucocorticoids; D003687:Dehydroepiandrosterone; D011241:Prednisone