title: Effects of prasterone on bone mineral density in women with active systemic lupus erythematosus receiving chronic glucocorticoid therapy.
abstract: OBJECTIVE
  To assess prevention of bone mineral density (BMD) loss and durability of the response during treatment with prasterone in women with systemic lupus erythematosus (SLE) receiving chronic glucocorticoids.
  
  
  METHODS
  155 patients with SLE received 200 mg/day prasterone or placebo for 6 months in a double-blind phase. Subsequently, 114 patients were re-randomized to receive 200 or 100 mg/day prasterone for 12 months in an open-label phase. Primary efficacy endpoints were changes in BMD at the lumbar spine (L-spine) from baseline to Month 6 and maintenance of BMD from Month 6 to 18 for patients who received prasterone during the double-blind phase.
  
  
  RESULTS
  In the double-blind phase, there was a trend for a small gain in BMD at the L-spine for patients who received 200 mg/day prasterone for 6 months versus a loss in the placebo group (mean +/- SD, 0.003 +/- 0.035 vs -0.005 +/- 0.053 g/cm(2), respectively; p = 0.293 between groups). In the open-label phase, there was dose-dependent increase in BMD at the L-spine at Month 18 between patients who received 200 versus 100 mg/day prasterone (p = 0.021). For patients who received 200 mg/day prasterone for 18 months, the L-spine BMD gain was 1.083 +/- 0.512% (p = 0.042). There was no overall change in BMD at the total hip over 18 months with 200 mg/day prasterone treatment. The safety profile reflected the weak androgenic properties of prasterone.
  
  
  CONCLUSIONS
  This study suggests prasterone 200 mg/day may offer mild protection against bone loss in women with SLE receiving glucocorticoids. (ClinicalTrials.gov Identifiers NCT00053560 and NCT00082511).
authors.affiliation: Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, México. jsanchezguerrero7@gmail.com
authors.forename: Jorge
authors.initials: J
authors.lastname: Sánchez-Guerrero
authors.forename: Hilda E
authors.initials: HE
authors.lastname: Fragoso-Loyo
authors.forename: C Michael
authors.initials: CM
authors.lastname: Neuwelt
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Wallace
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Ginzler
authors.forename: Yvonne R S
authors.initials: YR
authors.lastname: Sherrer
authors.forename: Harris H
authors.initials: HH
authors.lastname: McIlwain
authors.forename: Pamela G
authors.initials: PG
authors.lastname: Freeman
authors.forename: Cynthia
authors.initials: C
authors.lastname: Aranow
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Petri
authors.forename: Atul A
authors.initials: AA
authors.lastname: Deodhar
authors.forename: Ellen
authors.initials: E
authors.lastname: Blanton
authors.forename: Susan
authors.initials: S
authors.lastname: Manzi
authors.forename: Arthur
authors.initials: A
authors.lastname: Kavanaugh
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Lisse
authors.forename: Rosalind
authors.initials: R
authors.lastname: Ramsey-Goldman
authors.forename: James D
authors.initials: JD
authors.lastname: McKay
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Kivitz
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Mease
authors.forename: Anne E
authors.initials: AE
authors.lastname: Winkler
authors.forename: Leslie E
authors.initials: LE
authors.lastname: Kahl
authors.forename: Albert H
authors.initials: AH
authors.lastname: Lee
authors.forename: Richard A
authors.initials: RA
authors.lastname: Furie
authors.forename: C Vibeke
authors.initials: CV
authors.lastname: Strand
authors.forename: Lillian
authors.initials: L
authors.lastname: Lou
authors.forename: Mumtaz
authors.initials: M
authors.lastname: Ahmed
authors.forename: Betty
authors.initials: B
authors.lastname: Quarles
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Schwartz
mesh_terms: D000328:Adult; D015519:Bone Density / Q000187:drug effects; D050071:Bone Density Conservation Agents / Q000008:administration & dosage* / Q000009:adverse effects; D003687:Dehydroepiandrosterone / Q000008:administration & dosage* / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy*; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced / Q000517:prevention & control*; D017698:Postmenopause
chemical_list: D050071:Bone Density Conservation Agents; D005938:Glucocorticoids; D003687:Dehydroepiandrosterone