In a new study, researchers found people with clinically active systemic lupus erythematosus (SLE) disease on standard of care can attain or achieve low disease activity (LLDAS) and meet the Definition of Remission in SLE (DORIS remission). Many people did not reach these goals with current treatments. Staying in low disease activity or remission for longer was linked with fewer flares and less organ damage, showing the need for the more targeted and effective treatments.
Researchers followed a cohort of 1,991 people with SLE who had clinical disease activity but were not in LLDAS or DORIS-remission for 2.5 years. Of the group, 70.9% achieved LLDAS and 55.6% met DORIS-remission within the time period. The researchers discovered a connection between longer time to LLDAS attainment and nephritis and low complement levels, and a shorter time to LLDAS with use of antimalarial and immunosuppressant therapies. Following the initial achievement of LLDAS and DORIS remission, 47.0% and 47.5% of patients experienced flares, respectively, while 9.5% and 7.9% developed organ damage within 24 months. Additionally, spending more time at target and using antimalarials was linked to a longer period before flares and organ damage. Conversely, reducing doses of glucocorticoids and immunosuppressants was associated with quicker onset of flares. Reducing immunosuppressants also led to faster organ damage.
The researchers concluded that LLDAS and DORIS remission are both achievable goals in people with SLE with clinically active disease. More target-driven approaches and effective treatments can help achieve attainment. Clinical trials using a treat-to-target strategy are needed to guide monitoring and treatment adjustments in SLE and improve outcomes. Learn more about strategies to embrace living with lupus fearlessly.
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