Dr. Buyon has received consulting fees and/or honoraria from Amgen, Aspreva, Bristol-Myers Squibb, Coley, Genentech Pharmaceutical, Human Genome Science, La Jolla Pharmaceutical, Pfizer, and Johnson & Johnson (less than $10,000 each) and has provided expert testimony for Grossman and Roth Attorneys-at-Law on one occasion in 2004.
Research Article
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The effect of moderate-dose corticosteroids in preventing severe flares in patients with serologically active, but clinically stable, systemic lupus erythematosus: Findings of a prospective, randomized, double-blind, placebo-controlled trial
Article first published online: 30 OCT 2006
DOI: 10.1002/art.22198
Copyright © 2006 by the American College of Rheumatology
Additional Information
How to Cite
Tseng, C.-E., Buyon, J. P., Kim, M., Belmont, H. M., Mackay, M., Diamond, B., Marder, G., Rosenthal, P., Haines, K., Ilie, V. and Abramson, S. B. (2006), The effect of moderate-dose corticosteroids in preventing severe flares in patients with serologically active, but clinically stable, systemic lupus erythematosus: Findings of a prospective, randomized, double-blind, placebo-controlled trial. Arthritis & Rheumatism, 54: 3623–3632. doi: 10.1002/art.22198
Publication History
- Issue published online: 30 OCT 2006
- Article first published online: 30 OCT 2006
- Manuscript Accepted: 2 AUG 2006
- Manuscript Received: 7 NOV 2005
Funded by
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). Grant Number: NIAMS-026
- NIH. Grant Number: NIH R01-AR-44690
REFERENCES
- 1, , , , . Analysis of the relationship between disease activity and damage in patients with systemic lupus erythematosus: a 5-year prospective study. Rheumatology (Oxford) 2004; 43: 1039–44.
- 2, , , , , , et al. Systemic lupus international collaborative clinics: development of a damage index in systemic lupus erythematosus. J Rheumatol 1992; 19: 1820–1.
- 3, . Outcome of systemic lupus erythematosus: a study of 66 patients over 7 years with special reference to the predictive value of anti-DNA antibody determinations. Scand J Rheumatol 1991; 20: 104–9.
- 4, , , , . Measurement of increases in anti–double-stranded DNA antibody levels as a predictor of disease exacerbation in systemic lupus erythematosus: a long-term, prospective study. Arthritis Rheum 1990; 33: 634–43.Direct Link:
- 5, , , , , . Laboratory tests as predictors of disease exacerbations in systemic lupus erythematosus: why some tests fail. Arthritis Rheum 1996; 39: 370–8.Direct Link:
- 6, , , , , , et al. Prevention of relapses in systemic lupus erythematosus. Lancet 1995; 345: 1595–9.
- 7, , , , , , et al. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1982; 25: 1271–7.Direct Link:
- 8, , , , , , et al. The effect of combined estrogen and progesterone hormone replacement therapy on disease activity in systemic lupus erythematosus: a randomized trial. Ann Intern Med 2005; 142: 953–62.
- 9, . Cox's regression model for counting processes: a large sample study. Ann Statistics 1982; 10: 1100–20.
- 10, , . Serologically active clinically quiescent systemic lupus erythematosus: a discordance between clinical and serologic features. Am J Med 1979; 66: 210–5.
- 11, . Immunologic factors and clinical activity in systemic lupus erythematosus. N Engl J Med 1968; 278: 533–8.
- 12, , . Longitudinal studies of anti-DNA antibody levels in SLE. Scand J Rheumatol Suppl 1975; 11: 52–8.
- 13, , . Correlation between levels of DNA antibodies and clinical disease activity in SLE. Ann Rheum Dis 1977: 36: 157–9.
- 14, , . Reassessment of the clinical significance of native DNA antibodies in systemic lupus erythematosus. Arthritis Rheum 1979; 22: 959–68.Direct Link:
- 15, , , . Anti-dsDNA and complement profiles as prognostic guides in systemic lupus erythematosus. Arthritis Rheum 1979; 22: 226–35.Direct Link:
- 16, . Immune complexes, complement, and anti-DNA in exacerbations of systemic lupus erythematosus. Medicine (Baltimore) 1981; 60: 208–17.
- 17, , , , , , et al. The predictive value of fluctuations in IgM and IgG class anti-dsDNA antibodies for relapses in systemic lupus erythematosus: a prospective long-term observation. Ann Rheum Dis 1997; 56: 661–6.
- 18, , , . Decreases in anti–double-stranded DNA levels are associated with concurrent flares in patients with systemic lupus erythematosus. Arthritis Rheum 2001; 44: 2342–9.Direct Link:
- 19, , . Activation of complement mediates antiphospholipid antibody-induced pregnancy loss. Lupus 2003; 12: 535–8.
- 20, , , , , , et al. Surface expression of gp165/95, the complement receptor CR3, as a marker of disease activity in systemic lupus erythematosus. Clin Immunol Immunopathol 1988; 46: 141–9.
- 21, , , , . Intravascular neutrophil (PMN) activation in SLE: dissociation between increased CD11b/CD18 (CR3) and decreased L-selectin (LS) expression on neutrophils (PMNS) [abstract]. Arthritis Rheum 1992; 35 Suppl 9: S192.
- 22, , , . Up-regulation of endothelial cell adhesion molecules characterizes disease activity in systemic lupus erythematosus: the Shwartzman phenomenon revisited. Arthritis Rheum 1994; 3: 376–83.Direct Link:
- 23, , , , , , et al. Increased nitric oxide production accompanied by the up-regulation of inducible nitric oxide synthase in vascular endothelium from patients with systemic lupus erythematosus. Arthritis Rheum 1997; 40: 1810–6.Direct Link:
- 24, , , , , . Circulating activated endothelial cells in systemic lupus erythematosus: further evidence for diffuse vasculopathy. Arthritis Rheum 2001; 44: 1203–8.Direct Link:
- 25, , . Significance of serum complement levels for diagnosis and prognosis of acute and subacute glomerulonephritis and lupus erythematosus disseminatus. Ann Intern Med 1960; 53: 636–46.
- 26, , , , , , et al. Human complement metabolism: an analysis of 144 studies. Medicine (Baltimore) 1975; 54: 165–78.
- 27, . Studies of the in vitro behavior of human C3 in normal subjects and patients. J Clin Invest 1967; 46: 2021–34.
- 28, . Decreased synthesis of the third component (C3) in hypocomplementemic systemic lupus erythematosus. Clin Exp Immunol 1972; 11: 21–9.
- 29, , . Quantitative and antigenic differences in complement component C4 between American blacks and whites. Complement Inflamm 1991; 8: 281–7.
- 30, , , , , , et al. Complement activation during systemic lupus erythematosus: C3a and C5a anaphylatoxins circulate during exacerbations of disease. Arthritis Rheum 1986; 29: 1085–9.Direct Link:
- 31, , , , , . Increased levels of plasma anaphylatoxins in systemic lupus erythematosus predict flares of the disease and may elicit vascular injury in lupus cerebritis. Arthritis Rheum 1988; 31: 632–41.Direct Link:
- 32, , , . Assessment of disease activity and impending flare in patients with systemic lupus erythematosus: comparison of the use of complement split products and conventional measurements of complement. Arthritis Rheum 1992; 35: 1028–37.Direct Link:
- 33, , , , , . Complement activation and vascular injury in systemic lupus erythematosus. J Rheumatol 1987; 14 Suppl 13: 43–6.
- 34, . Activation of the complement pathway: comparison of normal pregnancy, preeclampsia, and systemic lupus erythematosus during pregnancy. Am J Reprod Immunol 1992; 28: 183–7.
- 35, , , , . Activation of the alternative complement pathway accompanies disease flares in systemic lupus erythematosus during pregnancy. Arthritis Rheum 1992; 35: 55–61.Direct Link:
- 36, , , , . Radioimmunoassay of the attack complex of complement in serum from patients with systemic lupus erythematosus. N Eng J Med 1985; 312: 1594–9.
- 37, , , . Factor B activation products in patients with systemic lupus erythematosus: a marker of severe disease activity. Arthritis Rheum 1989; 32: 1406–13.Direct Link:
- 38, , , , , , et al. Sensitivity and specificity of plasma and urine complement split products as indicators of lupus disease activity. Arthritis Rheum 1996; 39: 1178–88.Direct Link:
- 39, , , , , , et al. Usefulness of detection of complement activation products in evaluating SLE activity. Lupus 2000; 9: 19–25.
- 40
- 41, . SLE: mechanism of vascular injury [review]. Hosp Pract (Minneapolis) 1998; 33: 107–10, 113–4, 119–22.
- 42, , , , , , et al. Prevalence and correlate of accelerated atherosclerosis in systemic lupus erythematosus. N Engl J Med 2003; 349: 2399–406.

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