Efficacy of low-dose prednisolone maintenance for saliva production and serological abnormalities in patients with primary Sjogren's syndrome

Objective To evaluate efficacy of low dose prednisolone maintenance in pati ents with primary Sjogren's syndrome. Methods An open, prospective pilot st udy of prednisolone for the treatment of 20 patients with primary Sjogren's syndrome was performed. Evaluations included the amount of whole saliva me asured by the Saxon test, serological abnormalities and oral symptoms. Resu lts Initial dosage of prednisolone was 15.0 +/- 1.5 (mean +/- SEM) mg/day. Maintenance dosage was 7.5-3.0 mg/day, Follow-up period was 26.3 +/- 3.8 mo nths (range 3-48), The amount of whole saliva significantly increased after 1 month of prednisolone therapy and the increase continued up to 48 months by maintaining low-dose prednisolone, A mean percent increase of whole sal iva from baseline ranged from +105.2 +/- 36.2% to +245.7 +/- 82.1%. Serum I gG, anti-SS-A/Ro, anti-SS-B/La antibodies and IgM rheumatoid factor levels significantly decreased throughout the study with partial decreases of IgA and IgM levels. The improvement of subjective oral symptoms was also confir med. Conclusion Low-dose prednisolone maintenance may have a worthwhile cli nical benefit in patients with primary Sjogren's syndrome that deserves fur ther evaluation in a controlled trial.