Studies of dehydroepiandrosterone (DHEA) as a therapeutic agent in systemic lupus erythematosus

Several lines of investigation led to the consideration of dehydroepiandrosterone (DHEA) as a candidate for hormonal therapy in systemic lupus erythematosus, including DHEA deficiency in patients with SLE, the effects of sex steroids on SLE, the immunomodulatory effects of DHEA, and the results of DHEA in animal models of SLE. Uncontrolled observations in 50 patients suggested that DHEA has overall benefits for lupus activity, alleviating specific lupus symptoms as well the systemic manifestations of lupus, with incremental benefits over 3 to 12 months of treatment. DHEA, which was very well tolerated and safe, appeared to decrease the number of lupus flares and to have a steroid sparing effect. These results were confirmed in a small placebo-controlled trial, although the results were of borderline statistical significance. Currently, a number of additional trials with DHEA are underway, and it is anticipated that DHEA will find its place as a useful agent in the treatment of SLE.