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Prolonged remission in systemic lupus erythematosus
Murray B Urowitz1, Marie Feletar, Ian N Bruce
1University of Toronto Lupus Clinic, Centre for Prognosis Studies in The Rheumatic Diseases, Toronto Western Hospital, University Health Network, Ontario, Canada. m.urowitz@utoronto.ca
The Journal of Rheumatology
|August 4, 2005
Summary
Prolonged remission in systemic lupus erythematosus (SLE) is rare, with only 1.7% of patients achieving a 5-year disease-free state. Vigilance for recurrence remains crucial despite current therapies for SLE patients.
Area of Science:
- Rheumatology
- Immunology
- Internal Medicine
Background:
- Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by unpredictable flares and remissions.
- Defining and achieving prolonged remission in SLE is critical for long-term patient outcomes and management strategies.
Purpose of the Study:
- To assess the frequency of prolonged remission in SLE using stringent criteria.
- To characterize patients who achieve sustained remission and their prognostic factors.
- To explore remission frequencies with less restrictive definitions.
Main Methods:
- A cohort of 703 SLE patients from a Lupus Clinic database (1970-1997) was analyzed.
- Prolonged remission was defined as a 5-year period with SLE disease activity index (SLEDAI) = 0 and no treatment.
- Serologically active, clinically quiescent (SACQ) state was also defined and analyzed.
Main Results:
- Only 1.7% of SLE patients achieved a 5-year complete remission without treatment.
- 6.5% achieved at least 1 year of complete remission.
- Patients in 5-year remission showed lower disease activity, fewer anti-DNA antibodies, and reduced medication use.
Conclusions:
- Sustained, complete remission in systemic lupus erythematosus is infrequent.
- Ongoing monitoring for disease flares is essential for SLE management, even in patients who have experienced remission.