Transitioning from Lupus Low Disease Activity State to remission in systemic lupus erythematosus: real-world evidence

作者：Dai Gao, Lanlan Ji, Xiaohui Zhang, Yanjie Hao, Wenhui Xie, Yong Fan, Zhuoli Zhang · 发表于：Frontiers in Immunology · 年份：2025 · DOI：10.3389/fimmu.2025.1546306 · 被引用次数：4 · 研究领域：Systemic Lupus Erythematosus Research、Cytomegalovirus and herpesvirus research、Rheumatoid Arthritis Research and Therapies

Objectives To identify predictors and barriers to achieving remission in systemic lupus erythematosus (SLE) patients after attaining Lupus Low Disease Activity State (LLDAS). Methods This study included patients from the Sle to TARget (STAR) cohort who did not fulfill LLDAS at baseline. The Kaplan-Meier method was used to estimate the cumulative probabilities of remission or flare after LLDAS attainment. Univariate and multivariable Cox proportional hazards models were employed to identify predictors of time to remission. Barriers impeding remission achievement were also investigated. Results Of 586 enrolled patients, 480 achieved LLDAS within 20.4 months (IQR 13.4-37.1). Among these, 369 patients who did not achieve remission simultaneously with LLDAS attainment and had ongoing follow-up were included in further analysis. Subsequently, 297 (80.5%) patients achieved remission, with median times to remission and flare of 12.4 and 24.4 months, respectively. Independent predictors of a shorter time to remission included older age at disease onset (HR 1.012, 95%CI=1.004-1.020, P =0.002), arthritis (HR 1.481, 95%CI=1.113-1.969, P =0.007), and gastrointestinal involvement (HR 1.994, 95%CI=1.230-3.232, P =0.005). Conversely, anemia (HR 0.564, 95%CI=0.428-0.743, P <0.001) was a risk predictor. Higher disease activity defined by SLE Disease Activity Index 2000 (HR 0.691, 95%CI=0.632-0.757, P <0.001) or the Physician’s Global Assessment (HR 0.062, 95%CI=0.031-0.127, P &am...