A study on the prognosis of discontinuation of hormone therapy in childhood-onset systemic lupus erythematosus

LI Shipeng; KUANG Weiying; DENG Jianghong; ZHANG Junmei; TAN Xiaohua; LI Chao; LI Caifeng

doi:10.3969/j.issn.1674-3806.2024.09.04

Abstract：Objective To evaluate the long-term prognosis of childhood-onset systemic lupus erythematosus(cSLE)after discontinuation of glucocorticoids(GC)therapy.Methods The clinical data of 15 patients with cSLE who were diagnosed in Beijing Children's Hospital,Capital Medical University from January 2006 to December 2020 were retro-spectively analyzed.All the patients underwent long-term follow-up and their GC therapy was discontinued before the age of 18,and the patients were followed up for at least 1 year after discontinuation of GC therapy.Results Of the 15 patients with cSLE,4 cases were diagnosed with lupus nephritis and 3 with neuropsychiatric lupus.All the patients were treated with oral prednisone at a median dose of 1.7(1.1,2.0)mg/(kg·d).The median time to reach lupus low disease activity state(LLDAS)was 30(18,36)months,and the median time to reach clinical remission was 38(26,46)months.All the patients maintained clinical remission and serologically normal[anti-double-stranded deoxyribonucleic acid(dsDNA)antibodies-negative and normal complement levels]before discontinuation of GC therapy.The duration of GC therapy was 53(45,82)months.After GC was discontinued,all the patients continued to take disease-modifying anti-rheumatic drugs(DMARDs).The median follow-up time after discontinuing GC therapy was 21(16,44)months.One padiatric patient experienced a mild relapse at the 8th month after discontinuation of GC therapy.Conclusion It is feasible for the cSLE patients to discontinue GC therapy after achieving long-term clinical remission.However,larger scale clinical studies are needed to further validate the feasibility of discontinuing GC therapy in the cSLE patients.