1Associate Professor, Skin & V.D. Department, Chhattisgarh Institute of Medical Sciences, Bilaspur
2Associate Professor, Department of Medicine, Chhattisgarh Institute of Medical Sciences, Bilaspur
3Assistant Professor, Dept of Biochemistry, Chhattisgarh Institute of Medical Sciences, Bilaspur
Online published on 4 July, 2016.
Treatment of collagen vascular diseases like systemic sclerosis, dermatomyositis, systemic lupus erythematosus (SLE) has been generally discouraging. Methyl-prednisolone pulse therapy has been used for various connective tissue disorders since long. The success of dexamethasone-cyclophosphamide pulse (DCP) therapy in pemphigus has prompted many a dermatologist to try it in other autoimmune diseases. We used intravenous dexamethasone cyclophosphamide pulse therapy to treat SLE.
Eleven patients (9 females and 2 males) of SLE between the ages of 20–48 years with classical clinical criteria laid by American Rheumatism Association criteria were treated by Dexamethasone-Cyclophosphamide pulse (DCP) therapy at our center for six to nine pulses.
The treatment resulted overall 75% improvement in SLE. In most of the patients, there was complete clinical remission with DCP therapy leading a better quality of life after 4 pulses. The side effects commonly observed with conventional daily dose regimen of corticosteroids were virtually absent, rather bacterial and candidal infections of the skin and oral mucosa were found due to continuous immune suppression in most cases.
We conclude that DCP is relatively safe and effective as compared to methylprednisolone pulse and side effects are also less compared to daily regimen of steroids. Majority of patients had good response after 3–4 pulses to allow them a normal life style.
We also observed that patients who reported early and put on pulse early responded better.
Systemic lupus erythematosus, Dexamethasone-cyclophosphamide pulse therapy, DCP therapy
