7 Prevention and treatment of adverse effects of corticosteroids in systemic lupus erythematosus

Corticosteroid therapy has had a major impact on improvement in disease activity and long-term survival in patients with systemic lupus erythematosus (SLE). Unfortunately, the therapeutic advantages are accompanied by many manifestations of toxicity, some of which are short term and potentially reversible, while others cause chronic irreversible damage. Many of these features of toxicity have similar presentations to manifestations of SLE disease activity, and must be distinguished in the individual patient. The features of corticosteroid toxicity are reviewed in this chapter, and means of prevention and/or treatment are discussed.