Observational studies have previously found associations between glucocorticoid therapy and irreversible organ damage in SLE. As glucocorticoid use and lupus disease activity are highly concordant, disease activity potentially confounds analysis of the contribution of glucocorticoid use to organ damage. This could be obviated through the study of damage accrual in patients without detectable disease activity.
We studied whether glucocorticoids contribute to damage accrual in SLE in the absence of disease activity, by analysing the effect of glucocorticoids on SLE damage accrual in patients with no clinical or serological lupus disease activity (SLEDAI-2K=0).
1707 SLE patients were recruited from 13 centres in 8 countries and followed longitudinally between 2013-2016. As per a standardised protocol, disease activity (SLEDAI-2K) and treatment details were recorded at each …