Reactivation of inactive systemic lupus erythematosus

To characterize the features of systemic lupus erythematosus (SLE) in patients who flare after a period of inactive disease, we conducted a retrospective chart review. We identified 24 records from SLE patients who had been tapered to 5 mg/day or less of prednisone for at least 3 months. No initial clinical disease manifestations correlated with subsequent flares. Patients receiving more aggressive therapy for their initial active disease flared less often than patients who received adequate but less aggressive therapy. Patients who were tapered off of steroids were 3.2 times more likely to flare than patients who were maintained on low doses of corticosteroid. Further prospective studies are indicated.