Reducing the average prednisone dose of a lupus patient by as little as 1mg a day can reduce the estimated risk of future organ damage by 3% researchers say.
Writing in Lupus Science & Medicine the researchers say their study is the first to quantify the risk of corticosteroid use on overall organ damage or individual organ damage by dose cut-off points endorsed in some SLE clinical trials.
Their analysis of patients from the Hopkins Lupus Cohort found a dose-response relationship between mean prior prednisone dose during follow-up and the risk of developing irreversible organ damage over time.
Patients who received prednisone doses (≥7.5 mg/day) were significantly more likely to develop any new organ damage over time, compared with those taking less than <7.5 mg/day.
Patients in the highest dose subgroup (prednisone dose ≥20 mg/day) were more than twice more likely to experience organ damage than those who received <7.5 mg/day (HR=2.514; p<0.001).
Of the total number of organ damage events that occurred, 13.7% were cataracts, 12.4% were osteoporotic fractures, and 9% were cardiovascular damage.
The most first-time organ damage events occurred within the musculoskeletal and ocular organ systems, suggesting that “these corticosteroid-related comorbidities might present prior to any other type of organ damage in patients with SLE,” the authors wrote.