Abstract

Presentation Number: 1507

Marie Feletar, Dominique Ibanez, Murray B. Urowitz, Dafna D. Gladman. Toronto Western Hospital, University of Toronoto, Toronto, ON, Canada

Systemic Lupus Erythematosus (SLE) is a chronic inflammatory disorder with disease exacerbations. The concept of disease quiescence or remission has not been uniformly defined. Objectives: 1)To determine the prevalence of prolonged complete remission (no clinical or serologic activity, on no medications for 5 years) in lupus and assess features associated with such sustained remission. 2) to evaluate prevalence of prolonged clinical remission (serologically active clinically quiescent.for 5 years)

Methods: Patients registered in a database between 1970 and 1997 with visits no more than 18 months apart were identified. Prolonged remission was defined as a 5 year consecutive period of no disease activity (SLEDAI =0) and without treatment (corticosteroids, antimalarials or immunosuppressants). Prolonged SACQ was defined as active serology (elevated dsDNA by Farr assay or hypocomplementemia) but no clinical activity on SLEDAI and no treatment.

Results: 704 patients fulfilled inclusion criteria. Of these 12 (1.7%) patients achieved PR. These included 10F, 2M with a mean age at diagnosis 37.9 +/-14.0 years, mean disease duration prior to remission 2.3 +/- 4.5 years. At disease presentation, comparing the PR group to the remainder of the cohort, there were no statistically significant differences between the groups. Comparing disease features present at any time leading up to the period of remission, the PR patients were statistically significantly less likely to have been on corticosteroid therapy (p= 0.046), immunosuppressant therapy (p=0.004) and less likely to be dsDNA positive (p=0.018). In addition they had a lower adjusted mean SLEDAI (AMS)(p<0.0001) than the remainder of the cohort. Eight(1.14%) patients fulfilled criteria for prolonged SACQ. Additional patients on antimalarial therapy alone who would otherwise have fulfilled criteria for PR and SACQ numbered 2 in each group.

Conclusion: Prolonged remission in lupus is rare. Therefore with current therapies continued vigilance for disease recurrence is necessary.

Disclosure: M. Feletar, None; D. Ibanez, None; M.B. Urowitz, None; D.D. Gladman, None.