Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands.
Ann Rheum Dis. 2010 Jun;69(6):1144-7. doi: 10.1136/ard.2009.117036. Epub 2009 Oct 22.
Dehydroepiandrosterone (DHEA) has been reported to improve fatigue and reduced well-being. Both are major problems in patients with systemic lupus erythematosus (SLE), even with quiescent disease. Low serum DHEA levels are common in SLE. The present work investigates the effects of DHEA administration on fatigue, well-being and functioning in women with inactive SLE.
In a double-blind, randomised, placebo-controlled study, 60 female patients with inactive SLE received 200 mg oral DHEA or placebo. Primary outcome measures were general fatigue, depressive mood, mental well-being and physical functioning. Assessments were made before treatment, after 3, 6 and 12 months on medication, and 6 months after cessation of treatment.
Patients from the DHEA and placebo group improved on general fatigue (p<0.001) and mental well-being (p=0.04). There was no differential effect of DHEA. The belief that DHEA had been used was a stronger predictor for improvement of general fatigue than the actual use of DHEA (p=0.04).
The trial does not indicate an effect of daily 200 mg oral DHEA on fatigue and well-being, and therefore DHEA treatment is not recommended in unselected female patients with quiescent SLE. Clinical Trials Registration Number NCT00391924.
脱氢表雄酮（DHEA）已被报道可改善疲劳和降低幸福感。这两者都是红斑狼疮（SLE）患者的主要问题，即使疾病处于静止期也是如此。SLE 患者血清中 DHEA 水平普遍较低。本研究旨在探讨 DHEA 对处于静止期的 SLE 女性患者的疲劳、幸福感和功能的影响。
在一项双盲、随机、安慰剂对照研究中，60 名处于静止期的 SLE 女性患者接受了 200mg 口服 DHEA 或安慰剂治疗。主要的疗效指标是全身疲劳、抑郁情绪、精神健康和身体功能。在治疗前、用药 3、6 和 12 个月以及停药 6 个月后进行评估。
DHEA 组和安慰剂组患者的全身疲劳（p<0.001）和精神健康（p=0.04）均有改善。DHEA 没有产生差异效应。相信使用了 DHEA 比实际使用 DHEA 更能预测全身疲劳的改善（p=0.04）。
该试验表明，每日口服 200mg DHEA 对疲劳和幸福感没有影响，因此不建议在未选择的静止期 SLE 女性患者中使用 DHEA 治疗。临床试验注册号：NCT00391924。
