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June 14, 2004 (Berlin) — Women with systemic lupus erythematosus
(SLE) who receive the androgenic adrenal hormone dehydroepiandrosterone
(DHEA) have an improved quality of life, including an improved libido,
according to Swedish researchers who presented their findings here
at the European Congress of Rheumatology, the annual meeting of
the European League Against Rheumatism (EULAR).
"The formulation we used is available by prescription only
in Sweden," said principal investigator Gunnel Nordmark, MD,
in a press briefing. Therefore, she said, the findings may not be
applicable to DHEA supplements purchased without a prescription.
Dr. Nordmark is a consultant with the rheumatology department at
the University of Uppsala in Sweden.
Earlier studies have detected subnormal serum levels of DHEA and
its sulfated form, DHEAS, in women with SLE, Dr. Nordmark said.
Although this finding may be due to ongoing glucocorticoid treatment,
DHEA and DHEAS serum levels are also low in steroid-naive SLE patients.
Further, women with Addison's disease and growth hormone deficiency
had both experienced benefits when taking DHEA supplements.
Therefore, the investigators enrolled 41 women with SLE who were
taking at least 5 mg prednisolone daily in a double-blind, randomized,
placebo-controlled study. The investigators followed the women for
six months, during which they took placebo, 30 mg of DHEA daily
if they were aged 45 years or younger, or 20 mg of DHEA daily if
they were at least 46 years old. After the double-blind period,
the investigators followed the women for an additional six-month
open phase and offered the treatment to all of the patients.
Dr. Nordmark and colleagues used four questionnaires to assess
the patients' quality of life at baseline and at six and 12 months.
At six months, the patients' partners completed a questionnaire
assessing the patients' mood and behavior.
When treated with DHEA, the women had increased serum levels of
DHEAS; at baseline the mean level was subnormal; after treatment
these levels were normal. The DHEA group improved in the Short Form-36
(SF-36) "role emotional" domain and in the Health-Related
Quality of Life-56 (HSCL-56) total score. Their partners reported
greater responses to the "gets more done" question compared
with placebo (P < .05 for all).
During the open phase, the women who had been receiving placebo
improved in the SF-36 "mental health" domain compared
with their six-month scores (P < .05). Dr. Nordmark said that
these women showed a trend toward improvement in the HSCL-56 total
score (P = .10). Both groups improved in McCoy's Sex Scale during
active treatment (P < .05).
DHEA replacement also decreased high-density lipoprotein cholesterol,
and it increased insulin-like growth factor-1 and hematocrit. Dr.
Nordmark said that she and her colleagues documented no effects
of treatment on bone density or disease activity, and they also
documented no serious adverse events.
"We found that this treatment improved quality of life for
women with SLE regarding their sense of well-being and their sexual
desire," Dr. Nordmark said. "Therefore, physicians can
offer DHEA to women with SLE who are experiencing either mental
distress or low sexual desire."
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