Efficacy of high-dose methylprednisolone and cyclophosphamide in childhood-onset systemic lupus erythematosus
Background Systemic lupus erythematosus (SLE) is a chronic, multisystem, autoimmune disease. Untreated SLE often become progressive and lead to increased risk of mortality. Corticosteroid and cyclophosphamide remain the treatment of choice for severe SLE. Disease activity assessed with SLE Daily Act...
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| Format: | Article |
| Language: | English |
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Indonesian Pediatric Society Publishing House
2020-04-01
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| Series: | Paediatrica Indonesiana |
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| Online Access: | https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/2313 |
| _version_ | 1818504383614156800 |
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| author | Putu Ayunda Trisnia Ketut Dewi KUmara Wati Komang Ayu Witarini Ida Bagus Ramajaya Sutawan Hendra Santoso |
| author_facet | Putu Ayunda Trisnia Ketut Dewi KUmara Wati Komang Ayu Witarini Ida Bagus Ramajaya Sutawan Hendra Santoso |
| author_sort | Putu Ayunda Trisnia |
| collection | DOAJ |
| description | Background Systemic lupus erythematosus (SLE) is a chronic, multisystem, autoimmune disease. Untreated SLE often become progressive and lead to increased risk of mortality. Corticosteroid and cyclophosphamide remain the treatment of choice for severe SLE. Disease activity assessed with SLE Daily Activity Index (SLEDAI).
Objective To compare the disease activity of childhood-onset severe SLE at the time of diagnosis, after completion of high dose methylprednisolone, and after three month of cyclophosphamide by using SLEDAI.
Methods This study was conducted in the Division of Pediatric Allergy and Immunology, Department of Child Health, Udayana University/Sanglah Hospital, Denpasar, Bali. Subjects were SLE patient aged 0-18 years who had severe clinical manifestations. Subject received therapy combination of high dose methylprednisolone and cyclophosphamide every 2 weeks for six doses. SLEDAI score was assessed at the time of diagnosis, after completion of high dose methylprednisolone, and after three month of cyclophosphamide.
Results During the study period, 51 children were diagnosed as SLE. Twenty-one subjects were included for analysis. Median SLEDAI score at the time of diagnosis was 23 (range 13-39). SLEDAI score after three months of cyclophosphamide was decreased to 2 (range 0-14). Post hoc analysis with Wilcoxon signed-rank test showed the improvement of SLEDAI score at the time of diagnosis and after three months of cyclophosphamide was statistically significant (Z=-4.016, P<0.0001).
Conclusion SLEDAI score reduced after completion of high-dose methylprednisolone and three month of cyclophosphamide therapy. |
| first_indexed | 2024-12-10T21:36:25Z |
| format | Article |
| id | doaj.art-d0c5e1b8a7f34652909a56f1f6c08b47 |
| institution | Directory Open Access Journal |
| issn | 0030-9311 2338-476X |
| language | English |
| last_indexed | 2024-12-10T21:36:25Z |
| publishDate | 2020-04-01 |
| publisher | Indonesian Pediatric Society Publishing House |
| record_format | Article |
| series | Paediatrica Indonesiana |
| spelling | doaj.art-d0c5e1b8a7f34652909a56f1f6c08b472022-12-22T01:32:38ZengIndonesian Pediatric Society Publishing HousePaediatrica Indonesiana0030-93112338-476X2020-04-016031172410.14238/pi60.3.2020.117-242313Efficacy of high-dose methylprednisolone and cyclophosphamide in childhood-onset systemic lupus erythematosusPutu Ayunda Trisnia0Ketut Dewi KUmara WatiKomang Ayu WitariniIda Bagus Ramajaya SutawanHendra SantosoUniversitas Udayana Medical Student, Bali, DenpasarBackground Systemic lupus erythematosus (SLE) is a chronic, multisystem, autoimmune disease. Untreated SLE often become progressive and lead to increased risk of mortality. Corticosteroid and cyclophosphamide remain the treatment of choice for severe SLE. Disease activity assessed with SLE Daily Activity Index (SLEDAI). Objective To compare the disease activity of childhood-onset severe SLE at the time of diagnosis, after completion of high dose methylprednisolone, and after three month of cyclophosphamide by using SLEDAI. Methods This study was conducted in the Division of Pediatric Allergy and Immunology, Department of Child Health, Udayana University/Sanglah Hospital, Denpasar, Bali. Subjects were SLE patient aged 0-18 years who had severe clinical manifestations. Subject received therapy combination of high dose methylprednisolone and cyclophosphamide every 2 weeks for six doses. SLEDAI score was assessed at the time of diagnosis, after completion of high dose methylprednisolone, and after three month of cyclophosphamide. Results During the study period, 51 children were diagnosed as SLE. Twenty-one subjects were included for analysis. Median SLEDAI score at the time of diagnosis was 23 (range 13-39). SLEDAI score after three months of cyclophosphamide was decreased to 2 (range 0-14). Post hoc analysis with Wilcoxon signed-rank test showed the improvement of SLEDAI score at the time of diagnosis and after three months of cyclophosphamide was statistically significant (Z=-4.016, P<0.0001). Conclusion SLEDAI score reduced after completion of high-dose methylprednisolone and three month of cyclophosphamide therapy.https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/2313sle, childhood-onset, sledai, high-dose methylprednisolone, cyclophosphamide |
| spellingShingle | Putu Ayunda Trisnia Ketut Dewi KUmara Wati Komang Ayu Witarini Ida Bagus Ramajaya Sutawan Hendra Santoso Efficacy of high-dose methylprednisolone and cyclophosphamide in childhood-onset systemic lupus erythematosus Paediatrica Indonesiana sle, childhood-onset, sledai, high-dose methylprednisolone, cyclophosphamide |
| title | Efficacy of high-dose methylprednisolone and cyclophosphamide in childhood-onset systemic lupus erythematosus |
| title_full | Efficacy of high-dose methylprednisolone and cyclophosphamide in childhood-onset systemic lupus erythematosus |
| title_fullStr | Efficacy of high-dose methylprednisolone and cyclophosphamide in childhood-onset systemic lupus erythematosus |
| title_full_unstemmed | Efficacy of high-dose methylprednisolone and cyclophosphamide in childhood-onset systemic lupus erythematosus |
| title_short | Efficacy of high-dose methylprednisolone and cyclophosphamide in childhood-onset systemic lupus erythematosus |
| title_sort | efficacy of high dose methylprednisolone and cyclophosphamide in childhood onset systemic lupus erythematosus |
| topic | sle, childhood-onset, sledai, high-dose methylprednisolone, cyclophosphamide |
| url | https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/2313 |
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