Background and aims To study the effect of disease remission on organ damage and quality of life(QOL) in Chinese patients with SLE.

Methods Adult patients who fulfilled the ACR criteria for SLE were identified and their remission status at last visits was determined by the European consensus criteria (complete/clinical remission ± immunosuppressive drugs). The increase in SLE damage index (SDI) in the preceding 5 years was compared between patients who were and were not in remission for ≥5 years. QOL of patients as assessed by the validated Chinese version of the SF36 and the LupusPRO.

Results 769 SLE patients were studied (92%women; age46.4±14.6 years, SLE duration 12.6±8.1 years). Clinical remission (serologically active) was present in 259 (33.7%) patients (median 43 months) and complete remission (clinically and serologically inactive) was present in 280 (36.4%) patients (median 51 months). Clinical and complete remission for ≥5 years was achieved in 64 (8.3%) and 129 (16.8%) of the patients, respectively. 53 (6.9%) patients in remission ≥5 years were taken off all medications including HCQ. Patients remitted for ≥5 years were older, and had significantly lower prevalence of renal and haematological disease. Moreover, these patients had significantly less SDI increment than those who did not remit (0.17±0.53 vs 0.67±1.10;p<0.001). Among 453 patients who had QOL assessment within 6 months of last visits, remission for ≥5 years was associated with significantly better SF36 and the health-related scores of the LupusPRO.

Conclusions Durable drug-free remission in SLE is uncommon. Patients with complete or clinical remission for ≥5 years have significantly less damage accrual and better QOL.