Daily glucocorticoid dose linked to poor outcomes in SLE

An association exists between daily glucocorticoid (GC) dose and worse patient-reported outcomes (PROs) in patients with systemic lupus erythematosus (SLE) who have achieved Lupus Low Disease Activity State (LLDAS), even after adjustments for potential confounders, according to a study.

A total of 234 patients and 1,338 LLDAS visits were included in the analysis. The adjusted analysis revealed the association between daily GC dose and worse outcomes in Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-F), the Lupus Foundation of America Rapid Evaluation of Activity in Lupus (LFA-REAL) PRO, and four of eight domains of the Lupus Quality of Life (LupusQoL).

In alternative analysis, patients in the high GC dose category showed a trend toward worse PRO scores in the adjusted analysis, while those in the lower GC dose category had a trend of better PRO scores.

This single-cohort study included the following PROs: FACIT-F, LupusQoL, physical and mental component summary scores of the 36-Item Short Form Health Survey, and the LFA-REAL.

The authors performed univariable and multivariable generalized estimating equations (GEE) and adjusted the multivariable models for potential confounders, including age at diagnosis, sex, socioeconomic status, educational level, ethnicity, disease duration, disease activity and damage, and antimalarial and immunosuppressant use.

GEE was also performed in the alternative analysis, involving patients categorized based on four prednisolone dose categories: 0, >0 and ≤2.5, >2.5 and ≤5 mg, and >5 and ≤7.5 mg.