[Methylprednisolone pulse therapy for SLE patients with CNS disorder]

A clinical trial was conducted in 22 SLE patients with central nervous system (CNS) disorder in which the efficacy of pulse methylprednisolone suleptanate at the dose of 400 mg or 800 mg (as methylprednisolone) was assessed. The symptoms of CNS disorder disappeared within 40 days after pulse therapy in all of the 16 patients with organic brain syndrome (OBS). No improvement in the symptoms took place in any but one of the five patients who had cerebrovascular disorder. One SLE patient with depression showed improvement 55 days after pulse therapy. In the patients with OBS who had not received pulse therapy until 28 days or more after onset of CNS disorder, the symptoms disappeared in 20 days or more in both 400 mg and 800 mg dose groups. On the other hand, five of the six patients given the dose of 800 mg within 10 days of occurrence of the disease experienced a complete relief of the symptoms in 10 days after pulse therapy. However, at least 13 days were required for complete relief in all the four patients of the 400 mg group. The adverse reactions reported consisted of hyperlipemia, diabetes mellitus, and infections such as thrush or herpes zoster. The above results suggest that methylprednisolone pulse therapy is useful in the treatment of CNS disorder associated with SLE, particularly in patients with OBS who are given the dose of 800 mg early after onset of the disease.