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CorticosteroidsQuestions asked to Dr E. Dhondt, rheumatologist, AZ Sint-Jan Brugge, in reference to his lecture on 19 September 1998 for the CIB-league department West-Vlaanderen: "Corticosteroids can be dangerous, but also life-saving".
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| A lupuspatient does not want a corticosteroid treatment, is there an alternative? |
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If the flare is limited to joint pains, the patient can do without corticosteroids, even if it would provide him/her a better quality of life. The doctor will always point at the advantages and disadvantages of this drug. Corticosteroids control the inflammation but do not cure the disease. In situations like pericarditis (inflammation of the pericardium, the membrane around the heart), which can occur with a major flare, corticosteroids are necessary.
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| Corticosteroids are anti-inflammatory. Wouldn't it be useful to take a part of the dose in the evening? |
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It is not advisable, as corticosteroids can cause sleep disorders. If prescription of high doses is necessary, two thirds of the dose can be taken in the morning and one third in the evening.
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| Is the appearance of a 'moonface' when a patient takes high doses of corticosteroids permanent? |
| When the amount of corticosteroids is lowered, this 'moonface' effect will be reduced gradually and mostly it will disappear completely.
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| How often should a patient taking corticosteroids have a medical check-up? |
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This varies for each patient and depends on the symptoms and degree of illness. A blood test and clinical examination every six months is a minimum. When a patient takes high doses of corticosteroids a bone densitometry has to be performed to check the evolution of bone decalcification.
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| Is it possible that a lupus patient loses weight due to corticosteroids? |
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A lupus patient can lose weight considerably due to her illness and accompanying eating disorders, but not due to the intake of corticosteroids, which causes the patient to gain weight. The muscle mass, however, is reduced, especially at the level of the limbs, which causes arms and legs to become thinner.
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| Can the intake of corticosteroids cause gastrointestinal complaints? |
Corticosteroids can cause gastric ulcers when taken in high doses for a prolonged period of time. It also depends on the susceptibility of the patient. Nevertheless, it is advisable to take medication to protect the stomach if the dose exceeds 16 mg methylprednisolone or an equivalent from another type of corticosteroids (8 mg if the patient has a history of a gastric ulcer).
 Lecture by Dr. E. Dhondt: "Corticosteroids can be dangerous, but also life-saving".Back to Articles
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