{
  "abstract": "Objectives Sustained drug-free remission may be the ultimate goal for patients with SLE; however, the probability of achieving it and predictors thereof have not been fully evaluated.Methods We studied SLE patients in a long-term longitudinal, multinational, multiethnic inception cohort; eligible patients were those who attended >1 annual visits and who were not in remission at the baseline visit. Sustained drug-free remission was defined as a SLEDAI-2K (excluding serology)=0, off prednisone and immunosuppressive drugs (IS) but antimalarials were allowed. Possible predictors included were sex, age at diagnosis, ethnicity, educational level, SLEDAI-2K domains at cohort entry, baseline disease duration, highest prednisone dose before baseline, prednisone dose at baseline, number of methylprednisolone (MP) IV pulses as well as the mean dose per pulse, IS and antimalarials at or before baseline. Univariable and multivariable Cox regression models (stepwise selection procedure, alpha to stay in the model of 0.05) were used. Model 1 assessed sustained drug-free remission for at least two years as the outcome, model 2 sustained drug-free remission for at least three years and model 3 for at least five years. Patients who achieved the indicated period of sustained remission but later lost it were included in the analysis.Results 959 patients were studied; the probability of achieving sustained remission for at least two years at five and 10 years were 4.4% and 16.9%, respectively. Black, Asian and Hispanic ethnicities were associated with a lower probability of remission in all three models; Caucasian ethnicity not from North America and age at diagnosis were associated with a higher probability of remission in models 1 and 2; the association with age appeared linear and not bimodal; renal involvement and anti-dsDNA were negatively associated with remission in model 1; baseline MP IV pulses and azathioprine use were negatively associated with remission in model 2. Higher daily baseline prednisone dose was negatively associated with sustained remission in model 3. All results are summarized in table 1.Abstract S7:04 Figure 1Probability of achieving sustained drug-free remission for at least two years per ethnic groupAbstract S7:04 Table 1Predictors of sustained drug-free remission for at least two, three and five years. Multivariable modelsConclusions Sustained drug-free remission in SLE is uncommon but not rare, and is predicted by sociodemographic characteristics and disease severity. Further studies are needed to determine the impact of new treatments on this outcome.",
  "authors": [
    {
      "affiliations": [
        "Universidad Cientifica del Sur, Grupo Peruano de Estudio de Enfermedades Autoinmunes Sistemicas, Lima, Peru",
        "Hospital Guillermo Almenara Irigoyen-EsSalud, Rheumatology Department, Lima, Peru"
      ],
      "name": "Manuel F Ugarte-Gil"
    },
    {
      "affiliations": [
        "University College London, Department of Medicine, London, UK"
      ],
      "name": "Anisur Rahman"
    },
    {
      "affiliations": [
        "Medical University of South Carolina, Charlestion, South Carolina, USA"
      ],
      "name": "Diane L Kamen"
    },
    {
      "affiliations": [
        "University of California at San Diego, School of Medicine, La Jolla, California, USA"
      ],
      "name": "Kenneth Kalunian"
    },
    {
      "affiliations": [
        "Karolinska Institutet/Karolinska University Hospital, Department of Medicine Solna, Stockholm, Sweden"
      ],
      "name": "Elisabet Svenungsson"
    },
    {
      "affiliations": [
        "Dalhousie University, Department of Medicine, Halifax, Nova Scotia, Canada"
      ],
      "name": "Alexandra Legge"
    },
    {
      "affiliations": [
        "Queen Elizabeth II Science Centre and Dalhousie University, Department of Medicine and Department of Pathology, Halifax, Nova Scotia, Canada"
      ],
      "name": "John Hanly"
    },
    {
      "affiliations": [
        "Schroeder Arthritis Institute, Krembil Research Institute, Center for Prognosis Studies in the Rheumatic Diseases, Toronto, Ontario, Canada"
      ],
      "name": "Murray Urowitz"
    },
    {
      "affiliations": [
        "University of Birmingham, College of Medical and Dental Sciences, Institute of Inflammation and Ageing, Birmingham, UK"
      ],
      "name": "Caroline Gordon"
    },
    {
      "affiliations": [
        "Hanyang University Hospital for Rheumatic Diseases, Seoul, South Korea"
      ],
      "name": "Sang-Cheol Bae"
    },
    {
      "affiliations": [
        "Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Inmunología y Reumatología, Mexico City, Mexico"
      ],
      "name": "Jaunita Romero-Diaz"
    },
    {
      "affiliations": [
        "Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Inmunología y Reumatología, Mexico City, Mexico",
        "University of Toronto, Division of Rheumatology, Toronto, Ontario, Canada"
      ],
      "name": "Jorge Sanchez-Guerrero"
    },
    {
      "affiliations": [
        "McGill University, Divisions of Rheumatology and Clinical Epidemiology, Montreal, Québec, Canada"
      ],
      "name": "Sasha Bernatsky"
    },
    {
      "affiliations": [
        "University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada"
      ],
      "name": "Ann Eliane Clarke"
    },
    {
      "affiliations": [
        "UCLA, Cedars Sinai/David Geffen School of Medicine, Los Angeles, California, USA"
      ],
      "name": "Daniel J Wallace"
    },
    {
      "affiliations": [
        "University College London, Department of Medicine, London, UK"
      ],
      "name": "David Alan Isenberg"
    },
    {
      "affiliations": [
        "Oklahoma Medical Research Foundation, Department of Clinical Pathology, Oklahoma City, Oklahoma, USA"
      ],
      "name": "Joan T Merrill"
    },
    {
      "affiliations": [
        "CHU de Québec – Université Laval, Centre ARThrite, Rheumatology, Quebec, Canada"
      ],
      "name": "Paul R Fortin"
    },
    {
      "affiliations": [
        "Schroeder Arthritis Institute, Krembil Research Institute, Center for Prognosis Studies in the Rheumatic Diseases, Toronto, Ontario, Canada"
      ],
      "name": "Dafna D Gladman"
    },
    {
      "affiliations": [
        "University of Manchester, Manchester Academic Health Sciences Center, Manchester, UK"
      ],
      "name": "Ian N Bruce"
    },
    {
      "affiliations": [
        "Johns Hopkins University School of Medicine, Division of Rheumatology, Baltimore, Maryland, USA"
      ],
      "name": "Michelle Petri"
    },
    {
      "affiliations": [
        "SUNY Downstate Medical Center, Department of Medicine, Brooklyn, New York, USA"
      ],
      "name": "Ellen M Ginzler"
    },
    {
      "affiliations": [
        "University of North Carolina, Thurston Arthritis Research Center. Chapel Hill, North Carolina. USA"
      ],
      "name": "Mary Anne Dooley"
    },
    {
      "affiliations": [
        "Northwestern University and Feinberg School of Medicine, Department of Medicine. Chicago, Illinois. USA"
      ],
      "name": "Rosalind Ramsey-Goldman"
    },
    {
      "affiliations": [
        "Allegheny Health Network, Lupus Center of Excellence. Pittsburgh, Pennsylvania. USA"
      ],
      "name": "Susan Manzi"
    },
    {
      "affiliations": [
        "Lund University, Department of Clinical Sciences Lund, Rheumatology. Lund. Sweden"
      ],
      "name": "Andreas Jönsen"
    },
    {
      "affiliations": [
        "The Feinstein Institute for Medical Research, Northwell Health Manhasset. Manhasset, New York. USA"
      ],
      "name": "Cynthia Aranow"
    },
    {
      "affiliations": [
        "The Feinstein Institute for Medical Research, Northwell Health Manhasset. Manhasset, New York. USA"
      ],
      "name": "Meggan Mackay"
    },
    {
      "affiliations": [
        "University of the Basque Country, BioCruces Bizkaia Health Research Institute. Balakaldo. Spain"
      ],
      "name": "Guillermo Ruiz-Irastorza"
    },
    {
      "affiliations": [
        "Emory University, School of Medicine, Division of Rheumatology. Atlanta, Georgia. USA"
      ],
      "name": "Sam Lim"
    },
    {
      "affiliations": [
        "Istanbul University, Istanbul Medical Faculty. Capa, Istanbul. Turkey"
      ],
      "name": "Murat Inanc"
    },
    {
      "affiliations": [
        "Copenhagen University, Copenhagen Research Center for Autoimmune Connective Tissue Diseases, Rigshospitalet. Copenhagen. Denmark"
      ],
      "name": "Soren Jacobsen"
    },
    {
      "affiliations": [
        "University of Manitoba, Departments of Medicine and Community Health Sciences. Winnipeg, Manitoba. Canada"
      ],
      "name": "Christine Peschken"
    },
    {
      "affiliations": [
        "Columbia University Irving Medical Center. New York, New York. USA"
      ],
      "name": "Anca Askanase"
    },
    {
      "affiliations": [
        "Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR). Rosario. Argentina"
      ],
      "name": "Bernardo A Pons-Estel"
    },
    {
      "affiliations": [
        "The University of Alabama at Birmingham, Heersink School of Medicine. Birmingham, Alabama. USA",
        "Universidad Peruana Cayetano Heredia, Facultad de Medicina. Lima. Peru"
      ],
      "name": "Graciela S Alarcón"
    },
    {
      "affiliations": [
        "Amsterdam University Medical Centers, Department of Rheumatology. Amsterdam. The Netherlands"
      ],
      "name": "Ronald F van Vollenhoven"
    }
  ],
  "title": "S7:04 Predictors of sustained drug-free remission in systemic lupus erythematosus (SLE). Data from the SLICC (systemic lupus international collaborating clinics) inception cohort",
  "uid": "731e99a7-eaed-5d80-ad33-8062876b6a44"
}