{
  "abstract": "Objectives Glucocorticoids (GCs) have been used for the treatment of systemic lupus erythematosus (SLE) for over 60 years. Current recommendations advocate for the lowest effective dose for the shortest period to reduce adverse effects (AEs). Nevertheless, limited information exists regarding patients’ perspectives on the effectiveness and safety of GC therapy.Aim To explore patients’ perception of the effectiveness and safety of GC treatment in SLE.Methods A cross-sectional survey was conducted among SLE patients fulfilling the 2019 EULAR/ACR classification criteria from four national centers. Data were analyzed using Stata 14.0.Results A total of 272 patients (91% women; mean age 49 years; mean disease duration 5–10 years) were included. Most lived in urban areas (76%) and 59% had at least secondary education. Only 11% had never used GCs. Among the 243 patients with GC exposure, 36% reported use for 1–5 years, 19% for 5–10 years, and 31% for over 10 years. Seventy percent took a median dose of less than 10mg and 3% of >20mg. Most patients (82%) considered GCs very important or essential for disease control. AEs were reported by 58%, most frequently weight gain (78%) and irritability (31%), but 67% believed that benefits outweighed risks. Patients were taking a mean of 2.2 SLE medications; 98% had received hydroxychloroquine and 80% at least one immunosuppressant (including biologics). Compared with other therapies, 27% considered GCs superior and 32% similar. Three-quarters attempted to discontinue GCs, and of these, 66% remained off therapy, mostly for >6 months. Among those who relapsed (34%), half restarted within three months, mainly for arthralgia, malaise, or fatigue. Longer disease duration (>10 years) was associated with more frequent AEs (p = 0.032), and shorter duration (<1 year) with higher GC doses (>10 mg, p < 0.001). Patients from rural areas were less often advised to stop GCs (p = 0.002), while those with higher education more often perceived benefits outweighing AEs (p < 0.001).Conclusions In this multicenter study, despite known risks, most patients considered glucocorticoids beneficial and worth taking, particularly those with higher educational levels. Understanding patients’ perspectives is essential to support shared decision-making and successful steroid withdrawal strategies.",
  "authors": [
    {
      "affiliations": [
        "Immune Mediated Autoimmune Diseases Unit/Medicine 4 Department, Prof. Fernando Fonseca Hospital, Amadora, Portugal"
      ],
      "name": "Catarina Favas"
    },
    {
      "affiliations": [
        "Immune Mediated Autoimmune Diseases Unit/Medicine 4 Department, Prof. Fernando Fonseca Hospital, Amadora, Portugal"
      ],
      "name": "Frederico Batista"
    },
    {
      "affiliations": [
        "Immune Mediated Autoimmune Diseases Unit/Medicine 4 Department, Prof. Fernando Fonseca Hospital, Amadora, Portugal"
      ],
      "name": "João Serôdio"
    },
    {
      "affiliations": [
        "Autoimmune Diseases Unit, Curry Cabral Hospital, Central Lisbon University Hospital, Lisbon, Portugal"
      ],
      "name": "Sara Dias"
    },
    {
      "affiliations": [
        "Autoimmune Diseases Unit, Curry Cabral Hospital, Central Lisbon University Hospital, Lisbon, Portugal"
      ],
      "name": "Anna Taulaigo"
    },
    {
      "affiliations": [
        "Autoimmune Diseases Unit, Curry Cabral Hospital, Central Lisbon University Hospital, Lisbon, Portugal"
      ],
      "name": "Vera Bernardino"
    },
    {
      "affiliations": [
        "Autoimmune Diseases Unit/Internal Medicine Department, Tâmega e Sousa Local Heath Unit, Penafiel, Portugal"
      ],
      "name": "Joana Sousa"
    },
    {
      "affiliations": [
        "Autoimmune Diseases Unit/Internal Medicine Department, Tâmega e Sousa Local Heath Unit, Penafiel, Portugal"
      ],
      "name": "Daniel Oliveira"
    },
    {
      "affiliations": [
        "Autoimmune Diseases Unit/Internal Medicine Department, Tâmega e Sousa Local Heath Unit, Penafiel, Portugal"
      ],
      "name": "Natália Oliveira"
    },
    {
      "affiliations": [
        "Holly Spirit Hospital, Alentejo Central Local Health Unit, Évora, Portugal"
      ],
      "name": "Margarida Jacinto"
    },
    {
      "affiliations": [
        "Holly Spirit Hospital, Alentejo Central Local Health Unit, Évora, Portugal"
      ],
      "name": "Ana Vieira"
    },
    {
      "affiliations": [
        "Holly Spirit Hospital, Alentejo Central Local Health Unit, Évora, Portugal"
      ],
      "name": "Rita Ribeirinho"
    },
    {
      "affiliations": [
        "Heart Clinic, Évora, Portugal"
      ],
      "name": "Tiago Tribolet"
    },
    {
      "affiliations": [
        "Immune Mediated Autoimmune Diseases Unit/Medicine 4 Department, Prof. Fernando Fonseca Hospital, Amadora, Portugal"
      ],
      "name": "José Alves"
    }
  ],
  "title": "PO:13:344 Patient-reported perceptions of corticosteroid effectiveness and safety in systemic lupus erythematosus: a multicenter study",
  "uid": "111a0672-e709-54f9-9f55-875d5c5028a8"
}