Factors Associated with Glucocorticoid Withdrawal in Systemic Lupus Erythematosus: A Multicentre ANSWER-SLE Cohort

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ID: 324968
2026
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Abstract
Abstract Objectives To examine the rate of glucocorticoid (GC) discontinuation and to identify factors associated with successful GC withdrawal in patients with systemic lupus erythematosus (SLE). Methods This multicentre retrospective study used data from the ANSWER-SLE cohort. Patients fulfilling the 2019 ACR/EULAR classification criteria and registered between October 2023 and May 2025 were included. Patients were classified by GC status at enrolment as follows: discontinued GCs (Group 1), GC-naïve (Group 2), or continuing GC therapy (Group 3). Results Among 1,689 patients, 107 (6.3%) were in Group 1, 130 (7.7%) in Group 2, and 1,452 (86.0%) in Group 3. Disease duration was longest in Group 3 (P<0.001). Group 2 had lower total 2019 classification scores (P=0.008), higher LLDAS attainment (P<0.001), and lower SLICC Damage Index scores (P<0.001). Group 1 had the highest concomitant use of hydroxychloroquine (HCQ) (P<0.001), mycophenolate mofetil (MMF) (P<0.001), and belimumab (P=0.001). In multivariable Cox regression analysis, older age at disease onset (HR=1.049, P<0.001), HCQ (HR=5.75, P<0.001), MMF (HR=1.82, P=0.009), and belimumab (HR=1.72, P=0.041) were independently associated with GC discontinuation. Conclusion GC withdrawal may be achievable in selected patients with SLE, particularly those receiving HCQ, MMF, and belimumab, and in patients with an older age at disease onset.
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Authors Haruna Fujiki, Ryu Watanabe, Ryuhei Ishihara, Masao Katsushima, Yuhei Fujisawa, Akira Onishi, Hideaki Tsuji, Takuya Kotani, Yumiko Wada, Yuji Nozaki, Toshihiko Shiga, Shuji Sumitomo, Hideki Oka, Hirofumi Miyake, Takao Fujii, S. Iwata, Yasuhiro Kato, Eri Itotagawa, Wataru Yamamoto, Yuya Fujita, Kazuo Fukumoto, Shinsuke Yamada, Motomu Hashimoto
Journal modern rheumatology
Year 2026
DOI
10.1093/mr/roag065
URL
https://doi.org/10.1093/mr/roag065
Keywords Keywords not found

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