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Study Suggests Cyclophosphamide May Be More Effective in Treating CNS Lupus Compared to Methylprednisolone

Monday, September 11, 2006

Study Suggests Cyclophosphamide May Be More Effective in Treating CNS Lupus Compared to Methylprednisolone

The authors of this paper conducted a systematic review of the scientific literature to assess the safety and effectiveness of cyclophosphamide compared to methylprednisolone to treat neuropsychiatric lupus (lupus that affects the central nervous system). They identified one study which involved thirty two patients that were randomly divided into two groups. One group was treated with cyclophosphamide by IV (intravenous or through a vein) and the other group was treated with steroids (methylprednisolone by IV). All participants were on oral steroids (prednisone) at the beginning of the study and their dose was decreased over the two-year duration of the study.

Study results showed that more of the IV cyclophosphamide patients improved than did the patients on methylprednisolone. Eighteen of 19 patients (95 percent) on cyclophosphamide had at least a 20 percent improvement in their symptoms, compared to only six of 13 patients (46 percent) on methylprednisolone. Disease activity, seizures and central nervous system damage also decreased more among patients receiving cyclophosphamide.

After six months of treatment, the patients on cyclophosphamide took less prednisone than the patients on methylprednisolone. Side effects, such as infections, high blood sugar and high blood pressure occurred about the same amount in people who took cyclophosphamide or methylprednisolone.

The results of this small study suggest that cyclophosphamide may improve symptoms of central nervous system lupus more than methylprednisolone. However, due to the limitations of the study, these results must be confirmed by additional studies involving a larger number of patients.

Click here to read the abstract.

V.F. Trevisani, A.A. Castro, J.F. Neves Neto, A.N. Atallah, Cochrane Database System Review, 2006, April 19;(2) CD002265

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Blogged on 9:17 PM

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