• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

Johns Hopkins Rheumatology

Show Search
Hide Search
  • About Us
    • Our History
    • Our Faculty
    • Rheumatology Fellowship
    • Administrative Core
    • Contact Us
    • eNews Signup
  • Make an Appointment
    • Clinic Information
    • Specialty Clinics
  • Our Research
    • Current Research Studies
    • Andrade Lab
    • Darrah Lab
    • Konig Lab
    • Rosen Casciola Lab
    • RDRCC
    • Bayview Immunomics Core (BIC)
  • Charitable Giving
    • Dr. John Welton Fellowship in Rheumatology
    • Dr. Ira T. Fine Discovery Fund
    • Dr. Nadia D. Morgan Memorial Fund
  • News
    • LEAP Magazine
  • Education
    • Advances in the Diagnosis and Treatment of the Rheumatic Diseases Course
    • RheumTV – Patient Education Video Library
Home / News / Research / Durable Remission is Rare in Systemic Lupus Erythematosus

Durable Remission is Rare in Systemic Lupus Erythematosus

October 7, 2016 By Erika Darrah

Summary

A new study by Theresa R. Wilhelm, M.D., Laurence S. Magder Ph.D., and Michelle Petri, M.D., M.P.H.  is the first to test four new, widely-agreed upon definitions of remission in SLE (DORIS definitions) in a large cohort of SLE patients, the Johns Hopkins Lupus Cohort. In general, remission refers to the relief from symptoms of a disease, but there are many definitions that include different criteria to define this state.  The authors found that only very few patients with SLE reach durable remission, regardless of defining remission on-treatment or off-treatment. The higher the patients’ disease activity and treatment was when they entered the analysis, the lower their chance was of achieving remission.

Why was this study done?

Since there is presently no cure for systemic lupus erythematosus (SLE), remission is the ultimate goal in its treatment. Even though there have been a number of studies on remission in SLE in the past few decades, they used different definitions of the concept. Until now, there has been no widely agreed-upon definition of remission, in particular with regard to duration and allowable treatment. Especially in a complex disease such as SLE in which severity and symptoms vary widely between individuals, it is important to have clearly defined treatment goals that lead to the best outcomes for patients. Currently there is a big effort being made in the clinical and scientific lupus communities to agree upon definitions of remission. This effort has resulted in the definitions proposed by an international collaboration (DORIS, Definitions of Remission in SLE, headed by Professor Ronald F. van Vollenhoven). This group has agreed on several possible definitions of remission. Our study is the first to test four of them in a large clinical cohort.

How was this study done?

We applied the new DORIS definitions of remission in SLE to the Johns Hopkins Lupus Cohort with over 2000 patients, to find out how many patients fulfill the different definitions, how long it takes patients to reach remission, how long it lasts, and if there are any patient characteristics that predict who will reach remission. Patients in this cohort are usually seen by a doctor several times a year for their routine clinical care and were followed for several years. At each visit, a large amount of clinical information was collected, including information on SLE disease activity, and relevant blood tests. We then used statistical tools to calculate the time to remission, durability of remission, and predictors of remission.

What were the major findings?

We found that it is easier for patients to reach remission when certain treatments were still allowed (hydroxychloroquine, immunosuppressive drugs, prednisone ≤5 mg/day), than to reach remission off most treatments (just hydroxychloroquine allowed). We also found that the durability of remission is very short, only about 3 months, regardless of the definition used. The higher the patients’ disease activity and treatment was when they entered our analysis, the lower their chance was of achieving remission.

What is the impact of this work?

In this study, we learned that remission in SLE patients is short and that it is more difficult to achieve treatment-free remission than remission on certain medications. This is the first step to understanding which definition(s) of remission predict the best outcomes for our patients. To achieve this, we have to analyze our present treatment strategies and critically evaluate how our patients are doing in the long run. In particular, it is important to identify the patients in whom treatment can be tapered without flare, and in whom disease activity is merely suppressed by effective therapies.

This research was supported by:

The National Institutes of Health grant R01 AR 43727.

Link to original research article:

Remission in systemic lupus erythematosus: durable remission is rare. Wilhelm TR, Magder LS, Petri M. Ann Rheum Dis. 2016 Aug 24.

http://ard.bmj.com/content/early/2016/08/24/annrheumdis-2016-209489.long

 

Receive the Latest News from Johns Hopkins Rheumatology

Receive the Latest News from Johns Hopkins Rheumatology

Join our mailing list to receive the latest news and updates from Johns Hopkins Rheumatology.

Interested In

You have Successfully Subscribed!

Filed Under: Research Tagged With: Featured 2

Erika Darrah

Erika Darrah, Ph.D. is an Assistant Professor of Medicine in the Johns Hopkins University Division of Rheumatology with an interest understanding the mechanisms that drive the development of rheumatic diseases.

Use of this Site

All information contained within the Johns Hopkins Division of Rheumatology website is intended for educational purposes only. Physicians and other health care professionals are encouraged to consult other sources and confirm the information contained within this site. Consumers should never disregard medical advice or delay in seeking it because of something they may have read on this website.

Primary Sidebar

  • Our History
  • Our Faculty
  • Administrative Core
  • Contact Us
  • eNews Signup

Rheumatology News

RheumTV Logo

Rheum.TV is an educational platform created to help patients living with a rheumatic disease. With over 100 disease education videos produced by the team at Johns Hopkins Rheumatology.

Visit RheumTV

Footer

Rheumatology Specialty Care Centers

  • Johns Hopkins Arthritis Center
  • Johns Hopkins Lupus Center
  • Johns Hopkins Lyme Disease Research Center
  • Johns Hopkins Myositis Center
  • Johns Hopkins Scleroderma Center
  • Johns Hopkins Sjögren’s Syndrome Center
  • Johns Hopkins Vasculitis Center

Connect with Us

  • Facebook
  • Twitter
  • YouTube
U.S. News and World Report Rankings Badge

Johns Hopkins Medicine

© 2023 Johns Hopkins Rheumatology - Patient Privacy