DHEA Improves Quality of Life in Women With SLE

Paula Moyer, MA

June 14, 2004

June 14, 2004 (Berlin) — Women with systemic lupus erythematosus (SLE) who receive the androgenic adrenal hormone dehydroepiandrosterone (DHEA) have an improved quality of life, including an improved libido, according to Swedish researchers who presented their findings here at the European Congress of Rheumatology, the annual meeting of the European League Against Rheumatism (EULAR).

"The formulation we used is available by prescription only in Sweden," said principal investigator Gunnel Nordmark, MD, in a press briefing. Therefore, she said, the findings may not be applicable to DHEA supplements purchased without a prescription. Dr. Nordmark is a consultant with the rheumatology department at the University of Uppsala in Sweden.

Earlier studies have detected subnormal serum levels of DHEA and its sulfated form, DHEAS, in women with SLE, Dr. Nordmark said. Although this finding may be due to ongoing glucocorticoid treatment, DHEA and DHEAS serum levels are also low in steroid-naive SLE patients. Further, women with Addison's disease and growth hormone deficiency had both experienced benefits when taking DHEA supplements.

Therefore, the investigators enrolled 41 women with SLE who were taking at least 5 mg prednisolone daily in a double-blind, randomized, placebo-controlled study. The investigators followed the women for six months, during which they took placebo, 30 mg of DHEA daily if they were aged 45 years or younger, or 20 mg of DHEA daily if they were at least 46 years old. After the double-blind period, the investigators followed the women for an additional six-month open phase and offered the treatment to all of the patients.

Dr. Nordmark and colleagues used four questionnaires to assess the patients' quality of life at baseline and at six and 12 months. At six months, the patients' partners completed a questionnaire assessing the patients' mood and behavior.

When treated with DHEA, the women had increased serum levels of DHEAS; at baseline the mean level was subnormal; after treatment these levels were normal. The DHEA group improved in the Short Form-36 (SF-36) "role emotional" domain and in the Health-Related Quality of Life-56 (HSCL-56) total score. Their partners reported greater responses to the "gets more done" question compared with placebo ( P < .05 for all).

During the open phase, the women who had been receiving placebo improved in the SF-36 "mental health" domain compared with their six-month scores ( P < .05). Dr. Nordmark said that these women showed a trend toward improvement in the HSCL-56 total score ( P = .10). Both groups improved in McCoy's Sex Scale during active treatment ( P < .05).

DHEA replacement also decreased high-density lipoprotein cholesterol, and it increased insulin-like growth factor-1 and hematocrit. Dr. Nordmark said that she and her colleagues documented no effects of treatment on bone density or disease activity, and they also documented no serious adverse events.

"We found that this treatment improved quality of life for women with SLE regarding their sense of well-being and their sexual desire," Dr. Nordmark said. "Therefore, physicians can offer DHEA to women with SLE who are experiencing either mental distress or low sexual desire."

EULAR 2004 Congress: Abstract OP0180. Presented June 11, 2004.

Reviewed by Gary D. Vogin, MD

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