Systemic lupus: tapering off immunosuppressants – new research

Experts investigating people with systemic lupus erythematosus found that a good proportion managed to successfully taper-off and discontinue treatment with immunosuppressants, they highlight at the Canadian Rheumatology Association Annual Meeting.
Researchers studied 1,678 people with systemic lupus erythematosus (SLE) of whom 973 were receiving immunosuppressants, 199 had attempted tapering and 99 had completely withdrawn prednisone. Average age at tapering was 40.4 years and average disease duration was 9.4 years.
Of the 99 people who had withdrawn prednisone, 25 people had symptom flares within two years. Of the 74 people who did not experience a flare, 46 had clinical follow-up data available beyond two years, and 17 experienced a flare after year two.

Key findings:
• 17% of patients experienced disease flare at one year
• 30% reported a flare at two years
• 46% reported a flare at three years
• 49% reported a flare at four years
• 51% reported disease flare activity at five years
Further analysis showed that about 75% of clinically stable patients with SLE who withdrew prednisone during remission were not likely to experience a disease flare within two years.
Patients who tapered down the dose of prednisone and withdrew gradually were less likely to flare, the researchers report.

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