Efficacy of Low-dose Prednisolone Maintenance for Saliva Production and Serological Abnormalities in Patients with Primary Sjögren's syndrome

• Published in: Internal Medicine Vol. 38; no. 12; pp. 938 - 943
• Main Authors: MIYAWAKI, Shoji, NISHIYAMA, Susumu, MATOBA, Kenichiro
• Format: Journal Article
• Language: English
• Published: Tokyo The Japanese Society of Internal Medicine 01.12.1999; Japanese Society of Internal Medicine
• Subjects: Adult; Biological and medical sciences; Ent. Stomatology; Female; Follow-Up Studies; Glucocorticoids - administration & dosage; Humans; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Pilot Projects; Prednisolone - administration & dosage; prednisolone therapy; Prospective Studies; Saliva - metabolism; Saxon test; Sjogren's Syndrome - blood; Sjogren's Syndrome - complications; Sjogren's Syndrome - drug therapy; xerostomia; Xerostomia - drug therapy; Xerostomia - etiology; Antineoplastic agent; Human; Immunopathology; Corticosteroid; Evaluation; Stomatology; Low dose; Treatment efficiency; Antiinflammatory agent; Autoimmune disease; Serology; Sjögren syndrome; Eye disease; Salivary gland disease; Adrenal hormone; Systemic disease; Primary; Pilot test; ENT disease; Immunosuppressive agent; Aptyalism; Prednisolone
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.38.938

Objective To evaluate efficacy of low dose prednisolone maintenance in patients with primary Sjögren's syndrome. Methods An open, prospective pilot study of prednisolone for the treatment of 20 patients with primary Sjögren's syndrome was performed. Evaluations included the amount of whole saliva measured by the Saxon test, serological abnormalities and oral symptoms. Results Initial dosage of prednisolone was 15.0±1.5 (mean±SEM) mg/day. Maintenance dosage was 7.5-5.0 mg/day. Follow-up period was 26.3±3.8 months (range 3-48). The amount of whole saliva significantly increased after 1 month of prednisolone therapy and the increase continued up to 48 months by maintaining low-dose prednisolone. A mean percent increase of whole saliva from baseline ranged from +105.2±36.2% to +245.7±82.1%. Serum IgG, anti-SS-A/Ro, anti-SS-B/La antibodies and IgM rheumatoid factor levels significantly decreased throughout the study with partial decreases of IgA and IgM levels. The improvement of subjective oral symptoms was also confirmed. Conclusion Low-dose prednisolone maintenance may have a worthwhile clinical benefit in patients with primary Sjögren's syndrome that deserves further evaluation in a controlled trial. (Internal Medicine 38: 938-943, 1999)