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PREDNISONE AND PREDNISOLONE IN THE TREATMENT OF SYSTEMIC LUPUS ERYTHEMATOSUS

Edmund L. Dubois, M.D.
JAMA. 1956;161(5):427-433. doi:10.1001/jama.1956.02970050029007.
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• Prednisone and prednisolone were used in treating 31 patients with active systemic lupus erythematosus. The pattern of clinical improvement closely paralleled that obtained in previous work with corticotropin and cortisone. The fever abated in 24 to 48 hours, joint pains disappeared in several days, and pleural effusions and cutaneous lesions subsided in one to two weeks.

The necessary dosages of these two drugs, in milligrams, are smaller than those for corticotropin and cortisone; side-effects were slower in appearing; and there was less sodium retention than with hydrocortisone. Nevertheless, when high dosages are required, a low-sodium diet is necessary in order to avoid edema and congestive heart failure and a regimen to prevent peptic ulcer must also be instituted. Two patients who received the largest doses developed sudden, severe glycosuria that was cleared up in one case by changing therapy to hydrocortisone and in the other by giving insulin.

The evident effectiveness of these two drugs, and their advantages in some situations, must be weighed against their increased ulcerogenic activity and their diabetogenic potency.

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