Background and aims SLE disease flares significantly contribute to morbidity and mortality in SLE. This study describes the characteristics and contributing factors to disease flares in a cohort of Filipino SLE patients.

Methods Included were SLE patients with disease flare seen consecutively from January 2012 to December 2015 at the Lupus Clinics of University of Santo Tomas (UST) Hospital, Manila, Philippines. Demographics, organ involvement and SLE flare severity by SELENA-SLEDAI Flare Index (SFI) were described. Contributing factors to flare were identified based on physician assessment notes and patient responses to the Life Experiences Survey (LES).

Results There were 100 disease flares in 73 patients (68 females). Mean age at SLE diagnosis was 25.15±8.57 years (4-43), disease duration at each flare occurrence was 7.40±4.42 (<1–21) years. Flares were severe in 60, mild to moderate in 40. Organ involvement included renal in 47 (32.41%), mucocutaneous 40 (27.59%), musculoskeletal 26 (17.93%), vasculitis 11 (7.59%), hematologic 11 (7.59%), neurologic 6 (4.14%), ocular (32.07%) and cardiopulmonary 1 (0.68%). Stress and infection in 35 (30.97%) each, were the leading contributors to flare. Others included non-compliance in 18 (15.93%), excess sun exposure 7 (6.20%), pregnancy 3 (2.66%), fetal loss 3 (2.66%), surgery and drugs during 1 (0.88%) flare occurrence each, and unknown in 10 (8.85%).

Conclusions Renal, mucocutaneous and musculoskeletal systems were most commonly involved in a disease flare. Stress and infection were the leading factors contributing to a flare. These findings underscore need for holistic management approach in SLE, integrating effective disease control with patient education