Background The efficacy of methylprednisolone pulse therapy is well-established however, the gold standard of treatment is quite expensive and associated with significant infectious complications. Currently, there are no published study comparing the effect of methylprednisolone pulse therapy versus dexamethasone pulse therapy. Hence, this research aims to compare the current standard of care (methylprednisolone) versus the alternative regimen (dexamethasone pulse therapy).

Methods The study employed descriptive cross-sectional study. The participants included are patients with Systemic Lupus Erythematosus (SLE) treated with either high-dose dexamethasone or methylprednisolone therapy. Data were collected via retrospective review of medical charts.

Results A total of 45 patients were included in the study, 98% of which are female and 62% were treated with dexamethasone. The most common presenting features of SLE were hematologic (87%) and nephritis (44%). There is no significant difference in any of the characteristics, presenting features and outcomes between dexamethasone and methylprednisolone-treated patients (all p’s>0.05) except for neurologic manifestations. The most common indication for methylprednisolone pulse and dexamethasone pulse therapy for all patients in the study is nephritis (38%). In our study, neuropsychiatric lupus is the most common indication for methylprednisolone pulsing-treated patients (53%) whereas, nephritis and anemia are the common indications for dexamethasone pulse therapy.

Conclusions The characteristics of patients treated with dexamethasone and methylprednisolone were similar except for neurologic manifestations. In addition, the clinical outcomes of dexamethasone patients were comparable to methylprednisolone. Dexamethasone is less expensive than methylprednisolone which is a good alternative option for patients that belongs to low-income group; however, Randomized Controlled Trials should be performed to provide higher level of evidence in terms of efficacy and safety.