Factors Associated with Glucocorticoid Withdrawal in Systemic Lupus Erythematosus: A Multicentre ANSWER-SLE Cohort.

IF 2.1 4区医学 Q3 RHEUMATOLOGY

Modern Rheumatology Pub Date : 2026-08-13 DOI:10.1093/mr/roag065

Haruna Fujiki, Ryu Watanabe, Ryuhei Ishihara, Masao Katsushima, Yuhei Fujisawa, Akira Onishi, Hideaki Tsuji, Takuya Kotani, Yumiko Wada, Yuji Nozaki, Toshihiko Shiga, Shuji Sumitomo, Hideki Oka, Hirofumi Miyake, Takao Fujii, Shigeru Iwata, Yasuhiro Kato, Eri Itotagawa, Wataru Yamamoto, Yuya Fujita, Kazuo Fukumoto, Shinsuke Yamada, Motomu Hashimoto

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引用次数: 0

Abstract

Objectives: To examine the rate of glucocorticoid (GC) discontinuation and to identify factors associated with successful GC withdrawal in patients with systemic lupus erythematosus (SLE).

Methods: This multicentre retrospective study used data from the ANSWER-SLE cohort. Patients fulfilling the 2019 ACR/EULAR classification criteria and registered between October 2023 and May 2025 were included. Patients were classified by GC status at enrolment as follows: discontinued GCs (Group 1), GC-naïve (Group 2), or continuing GC therapy (Group 3).

Results: Among 1,689 patients, 107 (6.3%) were in Group 1, 130 (7.7%) in Group 2, and 1,452 (86.0%) in Group 3. Disease duration was longest in Group 3 (P<0.001). Group 2 had lower total 2019 classification scores (P=0.008), higher LLDAS attainment (P<0.001), and lower SLICC Damage Index scores (P<0.001). Group 1 had the highest concomitant use of hydroxychloroquine (HCQ) (P<0.001), mycophenolate mofetil (MMF) (P<0.001), and belimumab (P=0.001). In multivariable Cox regression analysis, older age at disease onset (HR=1.049, P<0.001), HCQ (HR=5.75, P<0.001), MMF (HR=1.82, P=0.009), and belimumab (HR=1.72, P=0.041) were independently associated with GC discontinuation.

Conclusion: GC withdrawal may be achievable in selected patients with SLE, particularly those receiving HCQ, MMF, and belimumab, and in patients with an older age at disease onset.

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系统性红斑狼疮患者糖皮质激素戒断相关因素：多中心应答- sle队列研究

目的：研究系统性红斑狼疮（SLE）患者糖皮质激素（GC）停药率，并确定与GC成功停药相关的因素。方法：这项多中心回顾性研究使用了ANSWER-SLE队列的数据。纳入了2023年10月至2025年5月期间注册的符合2019年ACR/EULAR分类标准的患者。患者根据入组时的GC状态分为：停止GC（1组），GC-naïve（2组）或继续GC治疗（3组）。结果：1689例患者中，第1组107例（6.3%），第2组130例（7.7%），第3组1452例（86.0%）。结论：在特定的SLE患者中，特别是接受HCQ、MMF和贝利单抗治疗的患者，以及发病年龄较大的患者，GC戒断是可以实现的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Modern Rheumatology RHEUMATOLOGY-

CiteScore

4.90

自引率

9.10%

发文量

146

审稿时长

1.5 months

期刊介绍： Modern Rheumatology publishes original papers in English on research pertinent to rheumatology and associated areas such as pathology, physiology, clinical immunology, microbiology, biochemistry, experimental animal models, pharmacology, and orthopedic surgery. Occasional reviews of topics which may be of wide interest to the readership will be accepted. In addition, concise papers of special scientific importance that represent definitive and original studies will be considered. Modern Rheumatology is currently indexed in Science Citation Index Expanded (SciSearch), Journal Citation Reports/Science Edition, PubMed/Medline, SCOPUS, EMBASE, Chemical Abstracts Service (CAS), Google Scholar, EBSCO, CSA, Academic OneFile, Current Abstracts, Elsevier Biobase, Gale, Health Reference Center Academic, OCLC, SCImago, Summon by Serial Solutions