Lupus Patients Can Achieve Remission, But Maintaining It Remains a Challenge, Study Finds
Atlanta, GA - New research reveals that a meaningful proportion of individuals with active systemic lupus erythematosus (SLE) can reach a state of low disease activity or even remission, offering renewed hope for those battling the autoimmune disease. However, maintaining this improved state proves arduous, and relapse remains a concern, highlighting the urgent need for more targeted and effective lupus treatments.
The study, published recently, followed 1,991 peopel with clinically active SLE for 2.5 years. Researchers found that 70.9% achieved low disease activity (LLDAS) and 55.6% met the Definition of Remission in SLE (DORIS remission) during the study period. Importantly, longer durations in low disease activity or remission correlated with fewer disease flares and less organ damage, underscoring the benefits of sustained disease control.
Systemic lupus erythematosus is a chronic autoimmune disease that can cause inflammation affecting various organs, including the skin, kidneys, blood cells, brain, heart, and lungs. Standard treatment frequently enough involves a combination of medications aimed at managing symptoms and preventing flares. While current therapies can be effective, achieving and sustaining remission has been a long-standing challenge.
The research identified factors influencing time to achieving LLDAS. Longer times were associated with the presence of nephritis (kidney inflammation) and low complement levels (indicating immune system activation). Conversely,quicker attainment of LLDAS was linked to the use of antimalarial and immunosuppressant therapies.
Following initial remission, relapse rates remained significant. Within 24 months, 47.0% of patients who achieved LLDAS and 47.5% who met DORIS remission experienced flares. Organ damage developed in 9.5% and 7.9% of thes patients, respectively. Prolonged time spent in the target range of low disease activity, along with continued antimalarial use, was associated with a longer period before flares and organ damage occurred.
Notably, reducing doses of glucocorticoids and immunosuppressants was linked to a faster onset of flares, and reducing immunosuppressants also accelerated the development of organ damage.These findings emphasize the importance of carefully managing medication adjustments in lupus patients.
The study’s authors conclude that achieving LLDAS and DORIS remission are realistic goals for many individuals with active SLE. They advocate for a “treat-to-target” strategy, guided by clinical trials, to optimize monitoring and treatment adjustments, ultimately improving outcomes for people living with lupus.
