Prevalence and factors associated with long-term remission in cutaneous lupus: A longitudinal cohort study of 141 cases.

cutaneous lupus erythematosus discontinuation dose tapering hydroxychloroquine long-term remission remission systemic lupus erythematosus

Journal

Journal of the American Academy of Dermatology
ISSN: 1097-6787
Titre abrégé: J Am Acad Dermatol
Pays: United States
ID NLM: 7907132

Informations de publication

Date de publication:
08 2022
Historique:
received: 27 10 2021
revised: 22 03 2022
accepted: 28 03 2022
pubmed: 8 4 2022
medline: 22 7 2022
entrez: 7 4 2022
Statut: ppublish

Résumé

Little is known about the prevalence and factors associated with long-term remission in cutaneous lupus erythematosus (CLE). To assess the prevalence, the factors associated with remission, and the long-term remission with and without treatment during CLE. Longitudinal cohort study including biopsy-proven patients with CLE seen between November 1, 2019 and April 30, 2021, with at least 6 months of follow-up after diagnosis. Demographic data, CLE subtypes, remission status, and treatments were recorded. Remission was defined by a Cutaneous Lupus Erythematosus Disease Area and Severity Index activity score of 0. Long-term remission was defined by remission >3 years. Among 141 patients included (81% of women), 93 (66%) were in remission at last follow-up with a median duration since diagnosis of 11.4 years (interquartile range, 4.2-24.7). Long-term remission was observed in 22 (19%) of 114 patients with at least 3 years of follow-up, including 5 (4.4%) with no systemic treatment. Active smoking (odds ratio, 0.22 [95%CI: 0.05-0.97]; P = .04) and discoid CLE lesions (odds ratio, 0.14 [95%CI, 0.04-0.48]; P = .004) were associated with a lower risk of long-term remission. Partial retrospective data collection and tertiary center population. Long-term remission is rare in CLE and negatively associated with active smoking and discoid CLE.

Sections du résumé

BACKGROUND
Little is known about the prevalence and factors associated with long-term remission in cutaneous lupus erythematosus (CLE).
OBJECTIVES
To assess the prevalence, the factors associated with remission, and the long-term remission with and without treatment during CLE.
METHODS
Longitudinal cohort study including biopsy-proven patients with CLE seen between November 1, 2019 and April 30, 2021, with at least 6 months of follow-up after diagnosis. Demographic data, CLE subtypes, remission status, and treatments were recorded. Remission was defined by a Cutaneous Lupus Erythematosus Disease Area and Severity Index activity score of 0. Long-term remission was defined by remission >3 years.
RESULTS
Among 141 patients included (81% of women), 93 (66%) were in remission at last follow-up with a median duration since diagnosis of 11.4 years (interquartile range, 4.2-24.7). Long-term remission was observed in 22 (19%) of 114 patients with at least 3 years of follow-up, including 5 (4.4%) with no systemic treatment. Active smoking (odds ratio, 0.22 [95%CI: 0.05-0.97]; P = .04) and discoid CLE lesions (odds ratio, 0.14 [95%CI, 0.04-0.48]; P = .004) were associated with a lower risk of long-term remission.
LIMITATIONS
Partial retrospective data collection and tertiary center population.
CONCLUSION
Long-term remission is rare in CLE and negatively associated with active smoking and discoid CLE.

Identifiants

pubmed: 35390427
pii: S0190-9622(22)00549-7
doi: 10.1016/j.jaad.2022.03.056
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

323-332

Informations de copyright

Copyright © 2022 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Conflicts of interest The authors have no conflicts of interest to disclose.

Auteurs

Damien Fayard (D)

Sorbonne Université, Faculté de médecine, AP-HP, Service de Dermatologie et Allergologie, Hôpital Tenon, Paris, France; CHU Gabriel Montpied, Service de Médecine Interne, Clermont-Ferrand, France.

Camille Francès (C)

Sorbonne Université, Faculté de médecine, AP-HP, Service de Dermatologie et Allergologie, Hôpital Tenon, Paris, France.

Zahir Amoura (Z)

Sorbonne Université, Faculté de Médecine, AP-HP, Groupement Hospitalier Pitié-Salpêtrière, French National Referral Center for Systemic Lupus Erythematosus, Antiphospholipid Antibody Syndrome and Other Autoimmune Disorders, Service de Médecine Interne 2, Institut E3M, Inserm UMRS, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France.

Paul Breillat (P)

Sorbonne Université, Faculté de Médecine, AP-HP, Groupement Hospitalier Pitié-Salpêtrière, French National Referral Center for Systemic Lupus Erythematosus, Antiphospholipid Antibody Syndrome and Other Autoimmune Disorders, Service de Médecine Interne 2, Institut E3M, Inserm UMRS, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France.

Alexis Mathian (A)

Sorbonne Université, Faculté de Médecine, AP-HP, Groupement Hospitalier Pitié-Salpêtrière, French National Referral Center for Systemic Lupus Erythematosus, Antiphospholipid Antibody Syndrome and Other Autoimmune Disorders, Service de Médecine Interne 2, Institut E3M, Inserm UMRS, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France.

Patricia Senet (P)

Sorbonne Université, Faculté de médecine, AP-HP, Service de Dermatologie et Allergologie, Hôpital Tenon, Paris, France.

Annick Barbaud (A)

Sorbonne Université, Faculté de médecine, AP-HP, Service de Dermatologie et Allergologie, Hôpital Tenon, Paris, France.

Laurent Arnaud (L)

Service de Rhumatologie, Hôpitaux Universitaires de Strasbourg, Centre National de Références des Maladies Systémiques et Autoimmunes Rares Est Sud-Ouest (RESO), Université de Strasbourg, France.

François Chasset (F)

Sorbonne Université, Faculté de médecine, AP-HP, Service de Dermatologie et Allergologie, Hôpital Tenon, Paris, France. Electronic address: francois.chasset@aphp.fr.

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