Remission and low disease activity in Polish patients with systemic lupus erythematosus - real-life, five-year follow-up outcomes

OBJECTIVE: Remission in sys-temic lupus erythematosus (SLE) or Lupus Low Disease Activity State (LLDAS) are asso-ciated with less organ damage and thus create new perspectives for effective damage-limiting treatment. The aim of this study was to assess the occurrence of remission defined by The Definition of Remission In SLE (DORIS) and of LLDAS as well as their predictors in the Polish SLE cohort.PATIENTS AND METHODS: In this ret-rospective study data were collected on pa-tients with SLE that achieved at least one year of DORIS remission or LLDAS and were fol-lowed up for 5 years. Clinical and demograph-ic data were gathered; DORIS and LLDAS pre-dictors were determined by univariate regres-sion analysis.RESULTS: The full analysis set included 80 pa-tients at baseline and 70 at follow-up. Over half of patients with SLE (39; 55.7%) fulfilled the DO-RIS remission criteria. In this group, 53.8% (21) of patients were in remission on-treatment and 46.1% (18) in remission off-treatment. LLDAS was fulfilled by a cohort of 43 (61.4%) patients with SLE. Among patients that achieved DO-RIS or LLDAS at follow-up, 77% were not treat-ed with glucocorticoids (GCs). The most import-ant predictors for DORIS and LLDAS off -treat-ment were mean SLEDAI-2K score with cut-off of <= 8.0, treatment with mycophenolate mofetil or antimalarials, and the age at disease onset above 43 years. CONCLUSIONS: Remission and LLDAS are achievable goals in treating SLE as over half of study patients fulfilled the DORIS remission and LLDAS criteria. The identified predictors for DO-RIS and LLDAS indicate the importance of effec-tive therapy leading to reduction of GC use.