Benefits

We found three non-blinded RCTs. Burton et al.13 compared prednisolone, 30-80 mg/day, alone and in combination with azathioprine,

2-5 mg/kg/day. The addition of azathioprine resulted in a 45% reduction in prednisolone dose over a 3-year period.13 Roujeau et al. compared prednisolone, 0-3 mg/kg/day, alone and in

QUESTIONS

What are the effects of corticosteroids?

combination with plasma exchange. They found that less than half the total prednisolone dose was required in the plasma exchange group.14 Disease control was achieved within weeks in both groups - in the plasma exchange group with a mean ± SD dose of 0-52 ± 0-28 mg/kg/day and in the prednisolone-only group with 0-97 ± 0-33 mg/kg/day. Guillaume et al. compared prednisolone 1 mg/kg/day alone or in combination with either azathioprine (100 mg for body weight <60 kg and 150 mg for body weight <60 kg) or plasma exchange.15 This trial failed to confirm any benefit of combination therapy over prednisolone alone.

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