@article {Sadae000772, author = {Ken-ei Sada and Yu Katayama and Yosuke Asano and Keigo Hayashi and Yoshia Miyawaki and Keiji Ohashi and Eri Katsuyama and Takayuki Katsuyama and Mariko Takano-Narazaki and Yoshinori Matsumoto and Ryusuke Yoshimi and Yasuhiro Shimojima and Shigeru Ohno and Hiroshi Kajiyama and Kunihiro Ichinose and Shuzo Sato and Michio Fujiwara and Nobuyuki Yajima}, title = {Association of one-point glucocorticoid-free status with chronic damage and disease duration in systemic lupus erythematosus: a cross-sectional study}, volume = {9}, number = {1}, elocation-id = {e000772}, year = {2022}, doi = {10.1136/lupus-2022-000772}, publisher = {Archives of Disease in childhood}, abstract = {Objective It is still unclear how glucocorticoids (GCs) affect the long-term clinical course of patients with SLE. The objective of this study is to explore the factors associated with GC-free treatment status.Methods Using data from the lupus registry of nationwide institutions, GC dose at registration was compared between short, middle and long disease durations of \<5, 5{\textendash}20 and >=20 years, respectively. After excluding patients who never used GC, we evaluated the relationship between GC-free status and chronic damage using Systemic Lupus International Collaborating Clinics Damage Index.Results GC doses at enrolment of the 1019 patients were as follows: GC-free in 101 (10\%); 0\<prednisolone (PSL) <=5 mg/day in 411 (40\%); 5\<PSL <=7.5 in 169 (17\%); 7.5\<PSL <=10 in 194 (19\%) and PSL>=10 in 144 (14\%) patients. Of the patients who were not currently using GCs, patients who never used GC more frequently had short disease duration (66\% with short, 23\% with middle and 17\% with long disease duration, p=0.00029). Univariate analysis of patients who underwent GC treatment showed that patients without GCs exhibited older age, lower disease activity, less immunosuppressant and hydroxychloroquine use and higher C3 levels. Among patients with a disease duration of >=20 years, GC-free status was more frequent in patients without chronic damage (11\% vs 4\%, p=0.023). After adjusting for age, sex and disease activity, no chronic damage accrual was associated with GC-free status (OR 3.6, 95\% CI 1.1 to 11.3).Conclusion Even in the patients with long disease duration, one-point GC-free treatment status might be related to no chronic damage accrual.Data are available on reasonable request. The datasets used and analysed in the present study will be shared on reasonable request to the ethics committee of Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences (mae6605@adm.okayama-u.ac.jp).}, URL = {https://lupus.bmj.com/content/9/1/e000772}, eprint = {https://lupus.bmj.com/content/9/1/e000772.full.pdf}, journal = {Lupus Science \& Medicine} }