Clinicoimmunologic pattern, therapeutic response, and outcomes in connective tissue disease patients receiving steroid pulse therapy

Abstract

Objectives: The aim of the study was to examine the clinicoimmunologic pattern, therapeutic response, and long-term outcomes in connective tissue disease (CTD) patients who received steroid pulse therapy. Material and Methods: Patients diagnosed with CTD (including diffuse cutaneous systemic sclerosis [dcSS], systemic lupus erythematosus [SLE], subacute cutaneous lupus erythematosus [SCLE], mixed CTD [MCTD], or overlap syndrome) who received steroid pulse therapy (period July 2017–June 2019) were identified in the hospital database and their relevant data were retrieved. Patients were followed up in June 2020 and response to treatment was evaluated by a self-devised patient-reported assessment scale. Results: Among the CTDs (n = 22; M: F = 1:6.3. Mean age = 39.95 ± 11.2 years), dcSS (45.5%) was the most common CTD seen followed by SLE (31.8%), MCTD (9.1%), SCLE (9.1%), and overlap syndrome (4.5%). CTD patients most commonly presented with joint pains (77.2%) or Raynaud’s phenomenon (77.2%). Antinuclear antibody (ANA) was positive in all patients. Fourteen patients received methylprednisolone; seven dexamethasone pulse, and one received dexamethasone-cyclophosphamide pulse. Only 10 patients could be followed up (mean duration of follow-up = 12.8 ± 6.4 months); two had complete remission, that is, clear; two had considerable benefit. Two did not tolerate pulse therapy and two died. Conclusion: Pulsed steroids can be a well-tolerated therapeutic modality with some benefit in CTD patients presenting to a dermatologist.