Impact of Low Disease Activity, Remission, and Complete Remission on Flares Following Tapering of Corticosteroids and Immunosuppressive Therapy in Patients with Systemic Lupus Erythematous: A Multinational Cohort Study
The Lancet Rheumatology, 2023, Volume 5, Issue 10, e584 - e593 DOI: https://doi.org/10.1016/S2665-9913(23)00209-6
In this study, tapering of corticosteroids or immunosuppressive therapy in patients in LLDAS, remission, or complete remission was associated with excess flares versus continuing with therapy. Tapering in complete remission was associated with lower odds of flares compared with tapering in LLDAS or remission. In addition, patients with longer sustained duration of LLDAS or remission at the time of tapering had lower odds of flare and longer time to flare versus those with a shorter duration of LLDAS or remission.
Sustained Glucocorticoid Tapering in the Phase 3 Trials of Anifrolumab: A post hoc Analysis of the TULIP-1 and TULIP-2 Trials
Rheumatology (Oxford). 2023 doi: 10.1093/rheumatology/keac491
Pooled analysis of the TULIP trials demonstrates that sustained glucocorticoid (GC) tapering is associated with several clinical benefits in patients with moderate-to-severe SLE.
Flares after Hydroxychloroquine Reduction or Discontinuation: Results from the Systemic Lupus International Collaborating Clinics (SLICC) Inception Cohort
Ann Rheum Dis. 2021:annrheumdis-2021-221295. Epub ahead of print
Evidence suggests that hydroxychloroquine (HCQ) reduction/withdrawal may be safe in some stable patients, but in other settings it may be associated with disease flare. Almeida-Brasil, et al. sought to evaluate SLE flares following HCQ reduction or discontinuation versus HCQ maintenance. Their data suggest that maintaining HCQ was associated with a lower flare risk than reduction or discontinuation, even in patients with low disease activity or remission.