High-dose steroids could raise heart disease in people with lupus

 The risk of metabolic syndrome and cardiovascular disease in people with lupus could be increased by high-dose steroids, says new research, even with they are taken at an early stage in the progression of lupus.

Lupus causes the immune system to attack the body’s joints and internal organs and people with the disease are known to face an increased risk of cardiovascular disease. But now a study of 1,494 people with lupus suggests that use of high-dose steroids may contribute to this heightened cardiovascular risk.

The research team from the University of Manchester found that current use of the steroid prednisone was associated with an increased risk of metabolic syndrome, as was the steroid dose and the use of immunosuppressant drugs.

Greater degree of disability and disease activity, active kidney disease and age were also associated with an increased risk of metabolic syndrome.

“While there have been improvements in (lupus) treatment in recent decades, leading to decreases in early mortality, there doesn’t appear to have been any decrease in deaths from cardiovascular disease,” explains study lead, Dr Benjamin Parker.

“These findings support more personalised treatment in early systemic lupus erythematosus in an attempt to rapidly and effectively control disease while trying to reduce corticosteroid doses, with the goal of improving cardiovascular outcomes over time,” Dr Parker says.

Another study (funded by Arthritis Research UK) is looking at a new treatment regimen that reduces the high doses of steroids given to people with lupus nephritis (which affects the kidneys) which could change the management of the condition.