Bangladesh: A low-dose prednisolone regimen may be effective for the treatment of proliferative lupus nephritis (LN), indicates a recent study published in the journal International Journal of Rheumatic Diseases. Also, the rate of infections and steroid dose-related side effects were lower in the group.
Lupus nephritis is a common complication that occurs in people who have systemic lupus erythematosus (also known as lupus) -- an autoimmune disease in which the immune system produces proteins called autoantibodies that attacks one's own tissues and organs, including the kidneys.
In the study, Iftekhar Hussain Bandhan, Directorate General of Health Services, Dhaka, Bangladesh, and colleagues aimed to compare the efficacy of low-dose prednisolone with the conventional high-dose regimen in proliferative lupus nephritis for remission.
The open-label randomized clinical trial was performed in the Department of Rheumatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. The study included a total of 32 LN patients. They were categorized into low-dose (experimental) and high-dose (control) groups. Experimental and control groups respectively received oral prednisolone, 0.5 mg/kg/d, and 1 mg/kg/d for initial 4 weeks and then tapered. They were then followed for 24 weeks. At 24 weeks, the researchers assessed rates of renal remission (complete and partial). The disease activity, biochemical markers, and quality of life were evaluated at baseline and at 24 weeks.
Following were the study's key findings:
Complete renal remission was achieved by 66.7% of patients in each group.
Renal remission (partial/complete) was achieved by 86.7% and 83.3% of patients in the prednisolone low-dose group and high-dose group respectively.
In between groups, no significant difference was observed in the improvement of active urinary sediments, serum creatinine level, anti-double-stranded DNA level, complements level, disease activity and Short Form-12 score.
The prednisolone dose-related adverse events like cushingoid facies, abdominal stria, infections and serious adverse events like death occurred more in the high-dose prednisolone group.
Based on the findings, the researchers observed that a low-dose prednisolone regimen may be effective in LN. Also, this group had lower steroid dose-related side effects and rate of infections.
Reference:
The study titled, "Outcome of low-dose prednisolone use for the induction of remission in lupus nephritis patients," was published in the International Journal of Rheumatic Diseases.
DOI: https://doi.org/10.1111/1756-185X.14265