RESEARCH - DHEA does not work in Sjögren's syndrome

[Guest guest]

DHEA does not work in Sjögren's syndrome

Rheumawire

September 15, 2004

Nainggolan

Bethesda, MD - A pilot clinical trial of the steroid hormone

dehydroepiandrosterone (DHEA) in patients with Sjögren's syndrome (SS)

has shown no evidence of efficacy [1].

Reporting their findings in the August 15, 2004 issue of Arthritis &

Rheumatism, Dr Stanley R Pillemer (National Institute of Dental and

Craniofacial Research, Bethesda, MD) and colleagues say: " DHEA should

not be used as a dietary supplement nor should it be prescribed as a

treatment for SS until there is clear evidence for efficacy. "

SS is characterized by symptoms of dry mouth and dry eyes, lymphocytic

infiltration of exocrine and other epithelial tissues, autoantibody

production, and increased serum immunoglobulin levels. Low levels of

DHEA have been noted in patients with rheumatoid arthritis (RA),

systemic lupus erythematosus (SLE), and SS, the researchers note,

" suggesting a possible role for this steroid hormone in these autoimmune

disorders. "

Pillemer et al say they decided to conduct the pilot study after

discovering that many of their SS patients were taking DHEA in the form

of dietary supplements, which are widely available in the US and not

subject to rigorous safety and efficacy testing.

A 6-month double-blind pilot trial of oral DHEA (200 mg/day) vs placebo

was conducted in 28 SS subjects14 received the drug and 14 took placebo.

Outcome measures included visual analog scale questionnaires for dry-eye

and dry-mouth symptoms, ocular dye staining, and tests for stimulated

salivary flow, immunoglobulin G, and erythrocyte sedimentation rate

(ESR).

Apart from changes over the trial in the dry-mouth symptoms, no

significant differences were noted between the DHEA and placebo groups

for any of the other outcomes. Also, the improvement in dry-mouth

symptoms was only 9%, " which by the definition used in our study is not

clinically meaningful, " the researchers state. (A 20% improvement is

considered meaningful). " However, an isolated effect of DHEA on symptoms

of dry mouth cannot be ruled out, " they note.

DHEA appeared to be safe. " The adverse events seen in the trial were

generally mild, mostly minor acne. " But the potential for long-term

complications of administration of a steroid hormone such as DHEA

" cannot be excluded, " they note.

" Patients with SS should avoid using unregulated DHEA supplements, since

long-term adverse consequences of exposure to this hormone are unknown, "

they conclude.

Source

Pillemer SR, Brennan MT, Sankar V, et al. Pilot

clinical trial of dehydroepiandosterone (DHEA) versus placebo for

Sjögren's syndrome. Arthritis Rheum 2004; 51:601-604.

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org