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

Abstract

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.

Keywords: cutaneous lupus erythematosus; discontinuation; dose tapering; hydroxychloroquine; long-term remission; remission; systemic lupus erythematosus.