Success and Associated Factors of Steroid Withdrawal in Patients with Systemic Lupus Erythematosus at Ratchaburi Hospital, Thailand
Keywords:
success steroid withdrawal, systemic lupus erythematosus, antimalarial drugsAbstract
Objective: The study aimed to examine the success and associated factors of steroid withdrawal in patients with systemic lupus erythematosus (SLE) at Ratchaburi Hospital, Thailand.
Methods: A retrospective study based on medical records included consecutive patients with SLE who attended the outpatient unit in Ratchaburi Hospital. The success rate of steroid withdrawal without resuming in 1 year was studied and the associated factors were determined. Logistic regression was used to analyze the data.
Results: At Ratchaburi Hospital, 569 patients with SLE were treated with glucocorticoids and followed up for more than 1 year between September 2016 and August 2020. Of these, 200 patients (35.1%) who discontinued prednisolone were included in our study. Of the 200 patients, 87.5% were female. The mean (SD) age was 42.1 (14.0) years. The median SLE disease duration was 28.5 (ranging from 1 to 278) months. The success rate of steroid withdrawal was 89.5%. The findings from the univariate analysis revealed that some factors were associated with success, such as the use of antimalarial drugs at the time of steroid withdrawal, higher BMI, and slow reduction of steroids by decreasing prednisolone below 5 mg/day for more than 12 weeks before stopping with OR 29.67 (95% CI 2.93–300.23), 1.13 (95% CI 1.01–1.23), and 25.44 (95% CI 8.41–76.93) respectively.
Conclusion: The present study reported a high rate of steroid withdrawal success without the need to resume steroid use in a year. The use of antimalarial drugs, a higher BMI, and gradual reduction of prednisolone below 5 mg/day for more than 12 weeks before stopping were found to be associated with success. The study showed the feasibility of steroid withdrawal, and its implications could be useful in planning the SLE management.
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ลิขสิทธิ์บทความเป็นของผู้เขียนบทความ แต่หากผลงานของท่านได้รับการพิจารณาตีพิมพ์ลงวารสารแพทย์เขต 4-5 จะคงไว้ซึ่งสิทธิ์ในการตีพิมพ์ครั้งแรกด้วยเหตุที่บทความจะปรากฎในวารสารที่เข้าถึงได้ จึงอนุญาตให้นำบทความในวารสารไปใช้ประโยชน์ได้ในเชิงวิชาการโดยจำเป็นต้องมีการอ้างอิงถึงชื่อวารสารอย่างถูกต้อง แต่ไม่อนุญาตให้นำไปใช้ในเชิงพาณิชย์
