Can we treat systemic lupus erythematosus and other autoimmune diseases without oral steroids?
Enriquez Merayo E (1), Sciascia S (2,3), Roccatello D (2,3), Cuadrado MJ (1).
(1a) Rheumatology Department , Clinica Universidad de Navarra , Madrid , Spain.
(2b) Center of Research of Immunopathology and Rare Diseases- Coordinating Center of the Network for Rare Diseases of Piedmont and Aosta Valley, Department of Clinical and Biological Sciences , University of Turin , Turin , Italy.
(3c) SCU Nephrology and Dialysis, S. Giovanni Bosco Hospital, Department of Clinical and Biological Sciences , University of Turin , Turin , Italy.
Glucocorticoids (GCs) have traditionally been the center of systemic lupus erythematosus (SLE) treatment and they continue to be recommended by the EULAR and ACR as the first-line therapy for several autoimmune diseases [1–4].
In the last 30 years, the trend has been to add immunosup- pressive drugs in an effort to minimize GC side effects and at the same time to achieve better control of disease activ- ity .
Coinciding with the decrease in the use of GC, 5-year survival rate in patients with lupus nephritis has increased from 44% in 1953–1969 to 96% today [6,7].
Lupus low disease activity state includes prednisolone doses 7.5 as definition criteria, recognizing the deleterious effects of GC in SLE prognosis .
CITA DEL ARTÍCULO Expert Rev Clin Immunol. 2018 Oct 17:1-3. doi: 10.1080/1744666X.2018.1527219.