Effects of dehydroepiandrosterone supplement on health-related quality of life in glucocorticoid treated female patients with systemic lupus erythematosus.
The objective of this study was to evaluate the efficacy of low dose dehydroepiandrosterone (DHEA) on health-related quality of life (HRQOL) in glucocorticoid treated female patients with systemic lupus erythematosus (SLE). Forty one women ( >or= 5 mg prednisolone/day) were included in a double-blind, randomized, placebo-controlled study for 6 months where DHEA was given at 30 mg/20 mg ( <or= 45/ >or= 46 years) daily, or placebo, followed by 6 months open DHEA treatment to all patients. HRQOL was assessed at baseline, 6 and 12 months, using four validated questionnaires and the patients' partners completed a questionnaire assessing mood and behaviour at 6 months. DHEA treatment increased serum levels of sulphated DHEA from subnormal to normal. The DHEA group improved in SF-36 "role emotional" and HSCL-56 total score (both p<0.05). During open DHEA treatment, the former placebo group improved in SF-36 "mental health" (p<0.05) with a tendency for improvement in HSCL-56 total score (p=0.10). Both groups improved in McCoy's Sex Scale during active treatment (p<0.05). DHEA replacement decreased high-density lipoprotein (HDL) cholesterol and increased insulin-like growth factor I (IGF-I) and haematocrit. There were no effects on bone density or disease activity and no serious adverse events. Side effects were mild. We conclude that low dose DHEA treatment improves HRQOL with regard to mental well-being and sexuality and can be offered to women with SLE where mental distress and/or impaired sexuality constitutes a problem.
Nordmark
Gunnel
G
Department of Medical Sciences, Section of Rheumatology, University Hospital, Uppsala, Sweden. gunnel.nordmark@medsci.uu.se
Bengtsson
Christine
C
Larsson
Anders
A
Karlsson
F Anders
FA
Sturfelt
Gunnar
G
Rönnblom
Lars
L
D000276:Adjuvants, Immunologic / Q000494:pharmacology / Q000627:therapeutic use*; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D000368:Aged; D000728:Androgens / Q000097:blood; D003687:Dehydroepiandrosterone / Q000494:pharmacology / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology*; D008875:Middle Aged; D011239:Prednisolone / Q000494:pharmacology / Q000627:therapeutic use*; D011788:Quality of Life; D012727:Sex Characteristics; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism
D000276:Adjuvants, Immunologic; D000728:Androgens; D012738:Sex Hormone-Binding Globulin; D003687:Dehydroepiandrosterone; D007334:Insulin-Like Growth Factor I; D000324:Adrenocorticotropic Hormone; D011239:Prednisolone