High dose steroids lupus

The use of high-dose steroids may increase the risk of metabolic syndrome and cardiovascular disease in people with lupus , even when taken at an early stage in the disease's progression, preliminary research suggests.

People with lupus - an autoimmune disease that causes the immune system to mistakenly attack the body's joints and internal organs - are already known to face an increased risk of cardiovascular disease.

In fact, many people with lupus who die prematurely actually die from related cardiovascular causes.

An analysis of 1,494 patients from 11 countries, presented at the annual meeting of the British Society for Rheumatology, suggests that use of high-dose steroids may contribute to this increased cardiovascular risk.

Participants had an average age of 35 years and had typically been diagnosed with lupus months earlier.

Sixteen per cent of patients already had metabolic syndrome - a cluster of conditions associated with an increased risk of cardiovascular disease and type-2 diabetes - at the time of enrolment, which began in 2000.

A further 14 per cent of patients were newly diagnosed with metabolic syndrome during the first two years of their participation in the study, with 27 per cent having the syndrome at some point during the two-year follow-up period.

The researchers discovered that current use of the steroid prednisone was associated with an increased risk of metabolic syndrome, as was the steroid dosage and use of immunosuppressant drugs .

Other factors that were associated with an increased risk of metabolic syndrome included a greater degree of disability and disease activity, active kidney disease and age.

Researcher Dr Benjamin Parker, from the University of Manchester, told MedPage Today: "While there have been improvements in [lupus] treatment in recent decades, leading to decreases in early mortality, there doesn't appear to have been any decrease in deaths from cardiovascular disease.

"These findings support more personalised treatment in early systemic lupus erythematosus in an attempt to rapidly and effectively control disease while trying to reduce corticosteroid doses, with the goal of improving cardiovascular outcomes over time."

Arthritis Research UK is funding a clinical trial of a new treatment regime focusing on reducing the high doses of oral steroids given to patients with lupus nephritis (which affects the kidneys) which, if proven to work, could drastically change the management of the condition.

"Steroids cause numerous side-effects and contribute to the higher than normal death rate seen in patients with lupus, and defining a new treatment regime that avoids the use of oral steroids would be significant," added a spokeswoman.

Because blood clots can be a life-threatening symptom of lupus, these drugs thin the blood to prevent it from clotting too easily. Anticoagulant medications include low-dose aspirin and prescription heparin (Calciparine®, Liquaemin®) and warfarin (Coumadin®). In particular, if you are being treated with warfarin, you must be monitored by your doctor to be sure your blood does not become too thin. Anticoagulant therapy may be lifelong in some people with lupus. Very recent research shows that people’s genetic makeup may influence how they respond to warfarin; specifically, that people with variations in two genes may need lower warfarin doses due to differences in how the body breaks down (metabolizes) warfarin and regulates the ability of warfarin to prevent blood from clotting. Therefore the dosage and administration of warfarin must be individualized for each person

While the genetics of SLE are not very well understood, there is growing evidence for the involvement of specific genes in this complex autoimmune disease . Part of the complexity of this disease is due to the effects of both environment and genetics factors that may contribute to its development. [49] Further compounding our understanding of the etiology of the disease is the involvement of several organ systems. [50] Genetic studies of the rates of disease in families supports the genetic basis of this disease with a heritability of >66%. [51] Identical ( monozygotic ) twins were found to share susceptibility to the disease at >35% rate compared to fraternal ( dizygotic ) twins and other full siblings who only showed a 2–5% concordance in shared inheritance. [51]

There is no doubt that sunlight (more specifically UV light) has a major effect in activating the disease. Many patients notice that their rashes, as well as joint pains and other symptoms are worse after a period of sunbathing. Nevertheless, sun sensitivity is not a universal problem, and the majority of patients whose lupus is under control find no special need to avoid sunlight. Sun barrier creams have only been of limited help. Various local lupus groups have collected information from manufacturers in their own countries and have provided considerable guidance in choice of makeup and UV-barrier creams.

High dose steroids lupus

high dose steroids lupus

There is no doubt that sunlight (more specifically UV light) has a major effect in activating the disease. Many patients notice that their rashes, as well as joint pains and other symptoms are worse after a period of sunbathing. Nevertheless, sun sensitivity is not a universal problem, and the majority of patients whose lupus is under control find no special need to avoid sunlight. Sun barrier creams have only been of limited help. Various local lupus groups have collected information from manufacturers in their own countries and have provided considerable guidance in choice of makeup and UV-barrier creams.

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