SynthesisLupus science & medicine2022
Risk factors of flare in patients with systemic lupus erythematosus after glucocorticoids withdrawal. A systematic review and meta-analysis.
Synthesis in Lupus science & medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.
- The 2026 British Society for Rheumatology guideline for the management of children, young people and adults with systemic lupus erythematosus.Rheumatology (Oxford, England) · 2026Guideline
- Disease modification in lupus nephritis: towards a pathophysiology-based treatment paradigm.Nature reviews. Nephrology · 2026Review
- Effects of glucocorticoid withdrawal on relapse risk in systemic lupus erythematosus: A systematic review and meta-analysis.iScience · 2025Article
- Glucocorticoids discontinuation in systemic lupus erythematosus: a single-centre study.Rheumatology advances in practice · 2025Article
- No clear influence of treatment escalation on flare prevention in serologically active clinically quiescent patients with systemic lupus erythematosus: a retrospective cohort study.Rheumatology international · 2024Article
- No Effect of Low-Dose Glucocorticoid Maintenance Therapy on Damage in SLE Patients in Prolonged Remission: A Propensity Score Analysis of the Longitudinal Lupus-Cruces-Bordeaux Inception Cohort.Journal of clinical medicine · 2024Article
- Use of Glucocorticoids in SLE: A Clinical Approach.Mediterranean journal of rheumatology · 2024Review
- Article
- Article
- Weaning Maintenance Therapy in Lupus Nephritis: For Whom, When, and How?Kidney international reports · 2023Review
- Risk factors of significant relapse and appropriate maintenance therapy strategy in SLE-associated immune thrombocytopenia.Therapeutic advances in chronic disease · 2023Article
- The dichotomy of glucocorticosteroid treatment in immune-inflammatory rheumatic diseases: an evidence-based perspective and insights from clinical practice.Reumatologia · 2023Review
- Observational
- Glucocorticoid discontinuation in patients with SLE with prior severe organ involvement: a single-center retrospective analysis.Lupus science & medicine · 2022Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveGlucocorticoids (GC) withdrawal is part of the targets in current recommendations for SLE, but relapse is the most worrying issue. We aimed to investigate the predictors for flare in patients with SLE after GC withdrawal.
methodsWe systematically searched PubMed, EMBASE and Cochrane Library as well as Scopus databases up to 9 July 2021 for studies concerning predictive factors of relapses in patients with SLE after GC cessation. Pooled OR and 95% CI were combined using a random-effects or fixed-effects model.
results635 patients with SLE with GC discontinuation in 9 publications were eligible for the final analysis. Of them, 99.5% patients were in clinical remission before GC withdrawal. Serologically active yet clinically quiescent (SACQ) was associated with an increased risk of flare after GC withdrawal (OR 1.78, 95% CI (1.00 to 3.15)). Older age and concomitant use of hydroxychloroquine (HCQ) trended towards decreased risk of flare (weighted mean difference (WMD) -2.04, 95% CI (-4.15 to 0.06) for age and OR 0.50, 95% CI (0.23 to 1.07) for HCQ), yet not statistically significant. No significant association was observed regarding gender (pooled OR 1.75; 95% CI (0.59 to 5.20)), disease duration (WMD -11.91, 95% CI (-27.73 to 3.91)), remission duration (WMD -8.55, 95% CI (-33.33 to 16.23)), GC treatment duration (WMD -10.10, 95% CI (-64.09 to 43.88)), concomitant use of immunosuppressant (OR 0.86, 95% CI (0.48 to 1.53)).
conclusionYounger age and SACQ were potential risk factors of SLE flare among patients who discontinued GC. HCQ, but not immunosuppressant might prevent flare. GC withdrawal should be done with caution in this subgroup of patients.
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