Steroids for SLE

Glucocorticosteroids for SLE

Corticosteroids for SLE are used in many forms:

  • topical preparations for inflammatory rashes. See steroids for dermatitis
  • low dose oral therapy for mild SLE.
  • high dose oral or intravenous infusions for severe and life-threatening SLE.

The exact mechanism in SLE is unclear. Glucocorticosteroids directly decrease the number of circulating leukocytes, eosinophils and monocytes. At high doses, they inhibit cytokine release and prostaglandin and leukotriene production. By these actions the proliferation of B- and T-cells is inhibited.

The most appropriate dose is finding a balance between achieving the most adequate immunesuppressive effect and minimizing the adverse effects.

Prednisone and prednisolone are corticosteroids of choice in SLE.

Systemic use of corticosteroids can cause many serious adverse effects. During corticosteroid therapy the patient should be monitored for hypertension, Cushing's syndrome, hyperlipidemia, ulcer disease, diabetes, obesity, cataracts, insomnia, psychosis and opportunistic infections.


Which of the following mechanisms is responsible for the immunosuppressive action of corticosteroids?