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Published on: September 20, 2024
Relapse risk after glucocorticoid withdrawal in stable Sjögren's disease-associated interstitial lung disease: a
Ningxin Li1,2, Hui Huang3, Yimeng Jia1,2
1Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Objectives:
To explore the risk of relapse after glucocorticoids (GCs) withdrawal in patients with stable Sjögren's disease-associated interstitial lung disease (SjD-ILD).
Methods:
This was a single-center, retrospective cohort study conducted at Peking Union Medical College Hospital between February 2016 and January 2024. The study compared two treatment strategies for patients with stable SjD-ILD: GC withdrawal versus GC maintenance. The primary endpoint was to compare the relapse rates between the two groups over a 3-year follow-up period. The secondary endpoints included changes in pulmonary function, serological markers, and adverse events.
Results:
A total of 134 patients were included in this study, with 61 in the GC withdrawal group and 73 in the GC maintenance group. Over the 3-year follow-up, 16 patients (27.93%) in the withdrawal group and 19 patients (28.77%) in the maintenance group experienced a relapse. No significant difference was found in relapse rates between the two groups (HR = 1.011, 95% CI 0.517-1.977, p = 0.974). Changes in pulmonary function, ESR, hs-CRP, C3, and C4 levels showed no significant differences, while IgG changes differed at the 2- and 3-year follow-up (p < 0.05). Adverse event rates were similar between groups.
Conclusions:
GCs' withdrawal in patients with stable SjD-ILD did not increase the relapse risk compared to continuing low-dose GCs' therapy. These findings suggest that cautious GCs' withdrawal might be a viable option for patients with stable, clinically inactive SjD-ILD. Key Points • Glucocorticoid withdrawal in stable pSS-ILD did not increase relapse risk compared to continuing low-dose GC therapy.
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