Prolonged Clinical Remission in Patients with Systemic Lupus Erythematosus

Steiman, Amanda; Urowitz, Murray B.; Ibañez, Dominique; Papneja, Anjali; Gladman, Dafna D.

doi:10.3899/jrheum.131137

Cited by 95 publications

(114 citation statements)

References 31 publications

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“…In fact, remission in patients on treatment is more frequent than in those who are therapy-free. In a previous study by Steiman et al ,15 2.4% of patients (38/1613) achieved a clinical remission without taking corticosteroids and immunosuppressants, but this percentage doubled (4.5%, 72 patients) when considering remitted patients on medications.…”

Section: Discussionmentioning

confidence: 85%

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Prolonged remission in Caucasian patients with SLE: prevalence and outcomes

et al. 2015

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AIM: \ud \ud To assess the prevalence of prolonged remission in Caucasian patients affected with systemic lupus erythematosus (SLE) and its relationship with damage accrual.\ud \ud METHODS: \ud \ud Caucasian patients diagnosed with SLE between 1990 and 2009 and quarterly seen from 2009 to 2013 were included in the study. We defined remission as prolonged when lasting ≥5 consecutive years. Three levels of remission were defined using the SLE Disease Activity Index-2000 (SLEDAI-2K): complete remission: no disease activity in corticosteroid-free and immunosuppressant-free patients; clinical remission off corticosteroids: serologically active clinical quiescent (SACQ) disease in corticosteroid-free patients and clinical remission on corticosteroids: SACQ disease in patients taking prednisone 1-5 mg/day. Damage was measured by the SLICC/American College of Rheumatology Damage Index (SDI).\ud \ud RESULTS: \ud \ud 224 patients fulfilled inclusion criteria: 196 (87.5%) were women, mean±SD disease duration 11.2±6.8 years. During the 5-year follow-up, 16 patients (7.1%) achieved prolonged complete remission, 33 (14.7%) prolonged clinical remission off corticosteroids and 35 (15.6%) prolonged clinical remission on corticosteroids. At the multivariate analysis, vasculitis (OR 4.95), glomerulonephritis (OR 2.38) and haematological manifestations (OR 2.19) over the patients' disease course were associated with an unremitted disease. SDI increased more frequently in unremitted (72/140, 51.4%) than in remitted patients (22/84, 26.2%; p=0.001); SDI median increase was higher in unremitted than in remitted patients: 1 (0-3) vs 0 (0-2), respectively (p<0.001). At multivariate analysis, unremitted disease (OR 2.52) and high-dose corticosteroid intake (OR 2.35) were risk factors for damage accrual.\ud \ud CONCLUSIONS: \ud \ud Thirty-seven percent of our Caucasian patients achieved a prolonged remission, which was associated with a better outcome in terms of damage accrual

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Section: Discussionmentioning

confidence: 85%

“…Notably, other studies did not specify the dose of corticosteroids allowed in the definition of remission,7 15 18 thus including cases in which the disease was clinically quiescent, thanks to medium-to-high dose of steroids.…”

Section: Discussionmentioning

confidence: 99%

Prolonged remission in Caucasian patients with SLE: prevalence and outcomes

et al. 2015

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“…In adult patients, prolonged remission, defined as SLEDAI equal to zero for at least five years, was found in only 2.4%, confirming the low frequency of this status in a large cohort. 21 Other studies identified prolonged remission in only 2% to 7% of adult patients. 22 Despite difficult comparison in those studies due to differences in definitions of activity patterns and tools used, we observed a lower frequency of the LQ pattern, which in adults ranges from 4% to 44.3%.…”

Section: Discussionmentioning

confidence: 98%

Chronic active disease pattern predicts early damage in juvenile systemic lupus erythematosus

Sato

Corrente

Saad‐Magalhães

2015

Lupus

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“…Furthermore, clinical remission has been defined by the absence of clinical features in the presence of immunological markers such as anti-dsDNA positivity and/or low complement serum levels [10]. There is no full agreement concerning the remission duration, the disease activity indices used to define remission, the serologic markers to be considered, and the allowed treatments [70]. Several authors agree that in clinical practice low-dose glucocorticoids (i.e.…”

Section: Definition Of Remissionmentioning

confidence: 99%