Risk factors for flares after glucocorticoid discontinuation
| Factor | Fisher’s exact test | Cox proportional hazards model | |||
| Flare (−) (n=54) | Flare (+) (n=19) | P value | HR | P value (95% CI) | |
| Prior severe organ involvement | 36 (66.7) | 13 (68.4) | 1.0 | 1.19 | 0.73 (0.44 to 3.17) |
| Renal manifestations | 26 (48.1) | 9 (47.4) | 1.0 | 1.22 | 0.67 (0.48 to 3.10) |
| Neurological manifestations | 6 (11.1) | 0 (0.0) | 0.33 | N/A | N/A |
| History of treatment with PSL 1 mg/kg/day | 21 (38.9) | 8 (42.1) | 1.0 | 1.16 | 0.76 (0.46 to 2.91) |
| History of treatment with mPSL pulse therapy | 12 (22.2) | 4 (21.1) | 1.0 | 0.97 | 0.95 (0.32 to 2.95) |
| History of treatment with: B cell targeting/cytotoxic medication | 4 (7.4) | 0 (0.0) | 0.57 | N/A | N/A |
| Hypocomplementaemia on the day of glucocorticoid discontinuation | 12 (23.1) | 9 (50.0) | 0.04 | 3.77 | <0.01 (1.43 to 9.90) |
| Elevated anti-dsDNA antibody titre more than twice the limit of laboratory reference range on the day of glucocorticoid discontinuation | 3 (12.0) | 5 (55.6) | 0.02 | 4.84 | 0.02 (1.27 to 18.41) |
| Duration of SLE >5000 days | 21 (38.9) | 3 (15.8) | 0.09 | 0.43 | 0.18 (0.12 to 1.48) |
| Anti-Smith antibody | 4 (7.5) | 6 (31.6) | 0.02 | 3.50 | 0.01 (1.31 to 9.35) |
| Anti-SSA/Ro antibody | 22 (42.3) | 11 (57.9) | 0.29 | 2.19 | 0.10 (0.87 to 5.55) |
| Anti-RNP antibody | 7 (15.2) | 11 (64.7) | <0.01 | 6.80 | <0.01 (2.36 to 19.63) |
| HCQ use on the day of glucocorticoid discontinuation | 29 (53.7) | 7 (36.8) | 0.29 | 0.75 | 0.56 (0.29 to 1.97) |
| Immunosuppressant use on the day of glucocorticoid discontinuation | 30 (55.6) | 15 (78.9) | 0.10 | 3.17 | 0.04 (1.04 to 9.68) |
| Achievement of LLDAS on the day of glucocorticoid discontinuation | 52 (96.3) | 17 (89.5) | 0.28 | 0.25 | 0.07 (0.06 to 1.1) |
Values are expressed as number (%) unless otherwise specified.
HCQ, hydroxychloroquine; LLDAS, Lupus Low Disease Activity State; mPSL, methylprednisolone; N/A, not applicable; PSL, prednisolone; RNP, ribonucleoprotein.;