Intravenous dexamethasone pulse therapy in diffuse systemic sclerosis : a randomized placebo-controlled study

Thirty-five patients with diffuse systemic sclerosis were studied in a randomized, placebo-controlled, double-blind study. Seventeen patients received intravenous dexamethasone "pulse" therapy, while 18 patients received placebo. Each "pulse" consisted of 100 mg dexamethasone in...

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Bibliographic Details
Published in:Rheumatology international 1994-09, Vol.14 (3), p.91-94
Main Authors: SHARADA, B, KUMAR, A, KAKKER, R, ADYA, C. M, PANDE, I, UPPAL, S. S, PANDE, J. N, SUNDERAM, K. R, MALAVIYA, A. N
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Bones, joints and connective tissue. Antiinflammatory agents
Dexamethasone - administration & dosage
Dexamethasone - adverse effects
Dexamethasone - therapeutic use
Double-Blind Method
Drug Administration Schedule
Female
Humans
Infusions, Intravenous
Male
Medical sciences
Middle Aged
Pharmacology. Drug treatments
Scleroderma, Systemic - drug therapy
Treatment Outcome
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Summary:Thirty-five patients with diffuse systemic sclerosis were studied in a randomized, placebo-controlled, double-blind study. Seventeen patients received intravenous dexamethasone "pulse" therapy, while 18 patients received placebo. Each "pulse" consisted of 100 mg dexamethasone in 250 ml 5% dextrose infused intravenously over 1 h. Pulse therapy was repeated every month for 6 months. Assessment of disease status with various parameters was done at entry and at completion of trial, i.e. after 6 months. Significant improvement in skin involvement was seen in the study group, with the total skin score (TSS) decreasing from 28.5 +/- 12.2 to 25.8 +/- 12.8, while in the control group, TSS increased from 30.6 +/- 13.2 to 34.7 +/- 10. Similarly, significant improvement was noted in the flexion index. Other parametres that included extension index, maximum oral opening, range of movement of joints, functional disability score, Raynaud's phenomenon (frequency and duration), ESR, proteinuria, chest X-ray, ECG, lung function tests, barium swallow and antinuclear antibody were unchanged. Adverse effects of therapy were limited to an increased incidence of minor chest infections. It is concluded that intravenous pulse dexamethasone may be useful in the treatment of diffuse systemic sclerosis.
ISSN:0172-8172
1437-160X
DOI:10.1007/BF00300808