Confirmation of Effectiveness of Megadosing DHEA in the Treatment of Systemic Lupus

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Confirmation of Effectiveness of Megadosing DHEA in the Treatment of Systemic Lupus

Previous double-blinded research reported that huge (200 mg/day) doses of dehydroepiandrosterone (DHEA) led to decreasing prednisone need and reduction in clinical flares in a three-month trial with 28 systemic lupus erythematosus (SLE) patients.(1) The same research group has now extended its findings. In the new (uncontrolled) report, 50 SLE patients were given between 50 and 100 mg of DHEA per day for up to one year.(2) Patient and physician global assessments showed statistically significant improvement (by more than 2/3), with prednisone doses falling more than 50%.

The current trial serves two important functions. It supports (albeit without blinding) the idea that DHEA helps patients with SLE. In addition, however, it provides a rare opportunity to look at medium-range DHEA toxicity. Side effects consisted primarily of ache (54%), hirsutism (18%), alopecia (10%), and increased perspiration (8%). Testosterone levels tripled at one year, and 14% discontinued therapy as a result of androgenic side effects. An additional 30% dropped out due to the medication's lack of efficacy. Nonetheless, the authors concluded that DHEA was "safe and well tolerated during 12 months of therapy. Patients receiving DHEA showed significant improvements over baseline. DHEA may be of importance in the long-term management of SLE."

(1) van Vollenhoven RF, Engleman EG, McGuire JL. Dehydroepiandrosterone in systemic lupus erythematosus. Arthrit Rheum 1995; 38:1826-31.

(2) van Vollenhoven RF, Morabito LM, Engleman EG, McGuire JL. Treatment of systemic lupus erythematosus with dehydroepiandrosterone: 50 patients treated up to 12 months. J Rheumatol 1998; 25:285-9.

Natural Product Research Consultants, Inc.

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By Steve Austin

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