{
  "abstract": "Objectives Our objective is to evaluate steroid-free remission in a monocentric cohort of patients with SLE and to assess its relationship with steroid-related adverse events.Methods We retrospectively analyzed clinical and laboratory data from a monocentric cohort of patients fulfilling the 2019 ACR/EULAR classification criteria for SLE. Steroid-related damage was defined as the de novo occurrence of at least one of the following: diabetes mellitus, osteoporosis with fracture, arterial hypertension, cardiovascular events, cataract, or infection requiring hospitalization. Clinical remission was defined according to DORIS criteria. Associations between categorical variables were analyzed using the chi-square test or Fisher’s exact test, depending on group size.Results A total of 271 SLE patients (241 women, 88.9%) were included, with a mean age at disease onset of 33 ± 13 years and a mean follow-up of 12 ± 5 years.At the last follow-up visit, 163 (60.1%) were receiving hydroxychloroquine, 101 (37.3%) at least one non-biologic immunosuppressant, 36 (13.3%) Belimumab, 14 (5.2%) Anifrolumab, 4 (1.5%) Rituximab, and only 46 (17%) glucocorticoids, of whom 80.4% were on doses < 5 mg/day.Overall, 223 (82.3%) patients were in DORIS remission, while 48 (17.7%) still had disease activity [28 (10.3%) in LLDAS and 20 (7.4%) not meeting LLDAS or DORIS remission criteria].GC discontinuation at last visit was significantly associated with DORIS remission (p < 0.0001). Conversely, GC use was significantly associated with a history of renal (p = 0.0032) or serosal involvement (p = 0.0024).Eighty-four patients (31%) developed at least one steroid-related adverse event during follow-up. GC use at last follow-up correlated with the presence of at least one adverse event (p = 0.01), whereas continued hydroxychloroquine use was protective against GC-related damage (p = 0.001).Conclusions In our cohort, achievement of DORIS remission coincided with steroid discontinuation, indicating that steroid-free remission is a realistic clinical goal in SLE management. Steroid-free management of more inflammatory manifestations, such as renal or serosal involvement, remains an open challenge and highlights the existence of a patient subgroup in whom early initiation of biologic therapy may be crucial to enable GC sparing and prevent steroid-related damage.",
  "authors": [
    {
      "affiliations": [
        "Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy"
      ],
      "name": "Ginevra De Marchi"
    },
    {
      "affiliations": [
        "Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy"
      ],
      "name": "Luisa Occhipinti"
    },
    {
      "affiliations": [
        "Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy"
      ],
      "name": "Alessia Nano"
    },
    {
      "affiliations": [
        "Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy"
      ],
      "name": "Laura Di Centa"
    },
    {
      "affiliations": [
        "Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy"
      ],
      "name": "Benedetta Fazzi"
    },
    {
      "affiliations": [
        "Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy"
      ],
      "name": "Cinzia Fabro"
    },
    {
      "affiliations": [
        "Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy"
      ],
      "name": "Luca Quartuccio"
    }
  ],
  "title": "PT3:04 Correlation between clinical remission and steroid withdrawal in systemic lupus erythematosus: a retrospective analysis of a monocentric cohort characterized by intensive immunosuppressant use",
  "uid": "c2be7a62-c72d-5961-bb3e-f8dfae25107b"
}