Frontiers in Pediatrics (Oct 2023)

Remission and long-term remission of pediatric-onset systemic lupus erythematosus

  • Yi-Chieh Chen,
  • Chiann-Yi Hsu,
  • Ming-Chin Tsai,
  • Lin-Shien Fu,
  • Lin-Shien Fu,
  • Lin-Shien Fu,
  • Yung-Chieh Huang,
  • Yung-Chieh Huang,
  • Yung-Chieh Huang,
  • Yung-Chieh Huang

DOI
https://doi.org/10.3389/fped.2023.1272065
Journal volume & issue
Vol. 11

Abstract

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ObjectivesSystemic lupus erythematosus (SLE) is a chronic autoimmune disease with diverse clinical presentations and prognoses. Remission can be achieved with or without glucocorticoid (GC) use, and several recent studies have suggested that long-term remission can be achieved in a small portion of patients. Nevertheless, few studies have investigated remission or long-term remission in the pediatric-onset SLE subgroup. This study analyzed the characteristics and factors associated with long-term remission and GC use in pediatric-onset SLE.MethodsWe enrolled 226 patients aged <18 years who received a diagnosis of SLE between January 2006 and December 2016. Three remission condition groups were defined: (A) complete remission, (B) clinical remission off GCs, and (C) clinical remission on GCs. Long-term remission was defined as remission for more than 5 years. We analyzed the treatment durations before remission, durations of remission, and risk factors for non-remission with persistent GC use.ResultsDuring follow-up, 8 patients (3.5%) achieved complete remission, 35 patients (15.5%) achieved clinical remission off GCs, and 93 patients (41.2%) achieved clinical remission on GCs. In groups A, B, and C, 12.5%, 68.6%, and 65.6% of patients, respectively, remained in remission for >1 year.ConclusionThis study assessed remission of pediatric-onset SLE. Up to 60.2% of patients had clinical remission after treatment, and 19% of patients achieved remission off GCs. Long-term remission is rarer in pediatric-onset SLE than in adult-onset SLE.

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