Steroids in the Maintenance of Remission of Proliferative Lupus Nephritis

Corticosteroids in the Maintenance Therapy of Proliferative Lupus Nephritis: a Randomized Pilot Study

There is debate as to whether long-term low-dose steroids such as prednisolone help to suppress relapses of systemic lupus erythematosus (SLE) in patients who are in remission from their lupus nephritis. If low-dose prednisolone reduces relapses, these beneficial effects may be counter-balanced by the long-term side-effects associated with prednisolone. This pilot study will determine the feasibility of conducting a larger randomized control trial that will answer the question of whether or not long-term low-dose prednisolone (5 - 7.5 mg/day) reduces the flares of SLE in patients with previous lupus nephritis.

Inclusion Criteria:

• age at least 18 years
• diagnosis of SLE by ACR criteria
• diagnosis of proliferative lupus nephritis (ISN/RPS class III or IV)
• currently on prednisolone (5 to 20 mg/day)
• in partial or complete remission for at least 3 months

Exclusion Criteria:

• currently pregnant
• in end-stage renal failure
• receiving corticosteroids for an indication other than lupus nephritis