Abstract
Background and aims To evaluate clinical and immunological remission according to Systemic Lupus Erythematosus Disease Activity Index assessed by SLEDAI (version 2000) (Gladman et al, 2002).
Methods We observed clinical response to standard treatment in the cohort of 127 lupus erythematosus Polish patients (118 female and 9 male) with average age 43±6 years (range 18–63 years), average disease duration 7,8±5,6 years (range 1,0–15,0 years). All of them complained of renal and non-renal manifestations and were treated with oral and pulse glucocorticoids and immunosuppressive therapies (CTX, MMF, AZT, CsA, MTX) (Tab.1). As a background therapy 77% of these patients were on chloroquine or hydroksychloroquine (CQ/HCQ).
Results In most analysed cases despite of standard immunosuppressive therapies fulfiled remission criteria were not achieved (SLEDAI ≥6). Full remission defined as clinical (minimum moderate improvement in various clinical signs and symptoms) and immunological (significant decrease of anti-dsDNA antibodies and significant increase level of C3 or C4 complement) response were obtained only by 9 patients (7%). Unexpectedly over 86% of our lupus patients have moderate or severe activity according to SELENA/SLEDAI score.
Conclusions Patients with lupus activity who not achieve remission are potential target for more aggressive standard treatment or novel biologic therapy. Effective strategy of treatment our lupus patients is still unmet need.
