Dehydroepiandrosterone (DHEA) Supplementation in Rheumatic Diseases: A Systematic Review.

Q4 Medicine Mediterranean Journal of Rheumatology Pub Date : 2023-08-25 eCollection Date: 2023-09-01 DOI:10.31138/mjr.20230825.dd

Thelma L Skare, Elizabeth Hauz, Jozélio Freire de Carvalho

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Abstract

Background: Dehydroepiandrosterone (DHEA) is an adrenal hormone used to treat rheumatic conditions such as systemic lupus erythematosus (SLE), Sjogren's syndrome (SS), rheumatoid arthritis (RA) with controversial results.

Aim: To review the results of DHEA use in rheumatic diseases.

Methods: PubMed, Scielo, Scopus, and Embase databases were systematically searched for articles on the treatment of rheumatic diseases with DHEA between 1966 and April 2023.

Results: Twenty-one studies were identified: 13 in SLE, 5 in SS, 2 in RA, and 1 in fibromyalgia. DHEA use in SLE has shown a mild to moderate effect on disease activity, a positive effect on bone mineral density (BMD), and improved fatigue. The studies on SS showed a decrease in symptoms of dry mouth, but its performance did not differ from placebo in disease activity. In RA, a questionable effect on disease activity was noted. The only study on fibromyalgia failed to show any improvement. The drug was well tolerated; mild androgenic effects were the most common complaints.

Conclusion: DHEA seems to have a place in SLE treatment, where it improves BMD and disease activity. The use in RA, SS, and FM is questionable.

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脱氢表雄酮（DHEA）在类风湿性疾病中的补充：一项系统综述。

背景：脱氢表雄酮（DHEA）是一种肾上腺激素，用于治疗系统性红斑狼疮（SLE）、干燥综合征（SS）、类风湿性关节炎（RA）等风湿性疾病，其疗效存在争议。目的：综述DHEA在风湿性疾病中的应用效果。方法：系统检索PubMed、Scielo、Scopus和Embase数据库中1966年至2023年4月期间关于DHEA治疗风湿性疾病的文章。结果：21项研究被确定：SLE 13项，SS 5项，RA 2项，纤维肌痛1项。系统性红斑狼疮患者使用DHEA对疾病活动有轻度至中度影响，对骨密度（BMD）有积极影响，并改善疲劳。对SS的研究表明，口腔干燥症状有所减轻，但其表现与安慰剂在疾病活动方面没有差异。在RA中，注意到对疾病活动的影响值得怀疑。唯一一项关于纤维肌痛的研究没有显示出任何改善。该药物耐受性良好；轻度雄激素作用是最常见的主诉。结论：DHEA在系统性红斑狼疮的治疗中有一定的地位，它可以改善骨密度和疾病活动性。在RA、SS和FM中的使用值得怀疑。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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