Evaluation of Factors Associated with Remission in Patients with Systemic Lupus Erythematosus

Abstract

The purpose of this study was to identify the number of patients in remission and the long-term outcome of the disease, and their predictors. Methods: Of the 379 patients in our SLE Database, a total of 193 patients fulfilled the inclusion criteria. Remission was definition according to the definitions of remission in SLE. Demographic data, clinical course of patients, incidence of remission and duration were evaluated based on clinical symptoms and cases recorded in the clinical records of patients. Three levels of remission were defined, including remission on-treatment, remission off-treatment and complete remission. In addition, we have defined a sustained remission for each level of remission in which the remission should last at least 5 years. Results: During a median follow-up of 96 months, remission on-treatment and off-treatment, and complete remission were obtained in 88.1%, 38.9% and 13.5% of patients, respectively. Predictors of remission on-treatment in multivariate regression analysis were adherence to therapy and remission induction during 6 months after treatment. Predictors of remission off-treatment were age≥40 at the time of analysis and remission induction during 6 months after treatment. Poor outcome (SLE Damage Index ≥1) was observed in 28% of the patients. Age at disease onset<30, kidney and nervous system involvement, and SLEDAI-2K≥11 at the cohort entry were the risk factors of poor outcome in multivariate analysis. However, sustained remission on-treatment had a negative association with poor outcome.