Corticosteroids in Lupus

Corticosteroids are the mainstay of treatment of systemic lupus erythematosus, with most patients receiving them at some point in the course of their disease. Corticosteroid use is associated with significant side effects, including infections, hypertension, hyperglycemia, osteoporosis, avascular necrosis, myopathy, cataracts, and glaucoma. Dosing regimens are based on limited data, with the goal of adequately controlling inflammatory symptoms while minimizing steroid exposure in order to reduce adverse effects.

Key points

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Corticosteroids are the mainstay of therapy for patients with systemic lupus erythematosus but use is associated with numerous adverse effects.
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Treatment with corticosteroids should be tailored to control symptoms with the lowest possible dose for the shortest possible duration to minimize adverse effects.
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Comorbidities predisposing to adverse effects such as diabetes, cardiovascular disease, peptic ulcer disease, and osteoporosis should be evaluated and controlled when initiating corticosteroid therapy.