Possible discontinuation of glucocorticoids and complete withdrawal of therapy in patients with systemic lupus erythematosus / 中华皮肤科杂志

ABSTRACT

In recent years, great advances have been made in application of treat-to-target (T2T) strategy to the treatment of systemic lupus erythematosus (SLE). In T2T strategy, it is suggested that the main target in SLE treatment should be the attainment and maintenance of clinical remission; if clinical remission cannot be achieved, low disease activity could be an alternative target; when the treatment target is achieved and maintained for a period, physicians can try to taper glucocorticoids and, if possible, glucocorticoids should be withdrawn completely; in patients in sustained clinical remission, the next step would be to reduce and stop immunosuppressants and antimalarials; in patients in sustained low disease activity, the next step would be to taper immunosuppressants. In sum, T2T strategy offers the direction and provides the possibility of discontinuation of glucocorticoids and complete withdrawal of therapy in patients with SLE. This review summarizes the new concept of T2T in SLE treatment, and discusses the influence and guiding significance of T2T on discontinuation of glucocorticoids, immunosuppressants and antimalarials.