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Hormone May Help Women With Lupus

DHEA Builds Bone, Reduces Need for Steroids In Some
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WebMD Health News
Reviewed by Gary D. Vogin, MD

July 25, 2002 -- For people living with lupus, the treatment can often be as bad as the disease. Over time, the steroids used to manage the immune disorder can cause serious complications, including thinning bones and bone fractures, heart problems, muscle weakness, and cataracts.

But new research suggests that women with mild to moderate lupus may be able to lower their dosage of steroids by adding the male hormone prasterone to their treatment regimen. Roughly half of the women with active disease who took part in the study were able to significantly reduce their daily dosage of the corticosteroid prednisone when they also took the hormone.

And researchers say soon-to-be published data indicate that instead of weakening bones, prasterone actually appears to help build bone in women with lupus who are on steroids.

"This is a very exciting finding because there has never been a drug that built bone in people taking corticosteroids," lupus researcher Robert G. Lahita, MD, tells WebMD. "We know that this (male hormone) builds tissue and bone, but we had no idea that it could do this in lupus patients on steroids."

Roughly 1.4 million Americans are believed to have some form of lupus, and while the disorder can strike men, nine out of 10 of those afflicted are women. For unknown reasons, the immune system turns on itself and attacks the body's own tissues and organs. Joint pain, arthritis, fatigue, anemia, and kidney problems are common symptoms.

Prasterone -- also known as DHEA -- is a common male hormone that has been shown to delay the symptoms of lupus and reduce mortality from the disease in animal studies. Early human trials suggested that 200 mg per day of the hormone reduced the need for prednisone in women with mild to moderate lupus.

In this multicenter study, Lahita and colleagues attempted to confirm these findings in a larger trial. Their study, reported in the July issue of the journal Arthritis and Rheumatism, included 191 female lupus patients taking moderate daily doses of prednisone. The women were randomized to receive either placebo, 100 mg of prasterone, or 200 mg of prasterone daily for seven to nine months in addition to steroid treatment.

At the end of the trial period, 51% of the women with active disease given 200 mg of prasterone daily were able to reduce their dosage of prednisone from 10 to 30 mg per day to 7.5 mg or less. 38% of women treated with 100 mg of the hormone and 29% of those given placebo treatments had similar responses.

Most available lupus therapies have been around for decades, but Lahita says major treatment advances may be on the horizon thanks to promising biological research.

"I believe that within the next five years we will discover the cause of this disease, and we will be well on the way to finding much more effective therapies," he tells WebMD.

Arthritis Foundation Medical Director John Klippel, MD, shares Lahita's optimism. Klippel says the biotech industry is working to develop new drugs that target the specific genetic causes of lupus.

"The hope is that these new drugs will have few of the side effects that we see with existing therapies," Klippel tells WebMD. "I do believe we are going to see significant advances in this area within the next decade."

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