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A 1‐year study of two doses of steroid in combination with methotrexate and chloroquine in the treatment of patients with mild and moderate systemic lupus erythematosus
Authors:Ting LI  Shun‐Le CHEN  Daniel E. FURST  Chun‐De BAO  Li LI  Sheng CHEN
Abstract:Aim: This is a retrospective study on the efficacy and adverse effects of treating mild or moderate systemic lupus erythematosus without major organ involvement using small dosage prednisone combined with MTX and chloroquine (PMC). Methods: As a retrospective 1‐year follow‐up study, clinic outpatients (Rheumatology Department, Renji Hospital, Shanghai, China) were divided by predinisone dose (Group A, prednisone ≤ 0.2 mg/kg/d; Group B prednisone 0.5–0.6 mg/kg/d). All patients (N = 30 per group) were also administered methotrexate (7.5–10 mg/week) and chloroquine (250 mg/d). Efficacy and adverse effects of the two protocol drug regimens were compared. Results: The OUT Score of Group A was reduced from 2.10 ± 1.45 to 0.94 ± 0.73, and Group B from 2.93 ± 2.26 to 1.3 ± 1.29. The treatment was successful and there was no significant difference of efficacy between these two groups. However, the infection rate was much higher in Group B than in Group A (P < 0.001). Most infections occurred in the lung, while infections of the skin were recorded. There were also three patients who presented with Cushing syndrome in Group B. Aseptic necrosis of the femoral head was noted in Group B, but none in Group A. Conclusions: Systemic lupus erythematosus patients with mild or moderate activity, and without major organ involvement, can be controlled well with PMC. Otherwise, it was noted that higher doses of prednisone leads to more infections.
Keywords:chloroquine  methotrexate  prednisone  systemic lupus erythematosus  treatment
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