Understanding lupus

How is remission in lupus defined?

There is no formal, approved definition for lupus remission. However, the word “remission” is sometimes used to describe certain situations. One situation is a person who presents with a disorder which appears to be systemic features of lupus but after a while, their symptoms, physical exam findings, and blood abnormalities go back to normal and stay that way, even after any prescribed medications are stopped. Some doctors might feel that the person did not truly have lupus, but probably had something else causing lupus-like problems (which can be seen with certain infections, such as parvovirus infection.)

The more common usage of the term “remission” would be to be “in remission on medications, or quiescent (quiet)."" This would mean that the person with lupus is taking Plaquenil® (hydroxychloroquine) and/or other medications and is doing well with no evidence of lupus manifestations such as arthritis, rash, kidney involvement, blood cell count problems, etc. This is the goal for most people with lupus, but is not always possible.

When a person is in remission while taking medications, doctors always try to taper steroids down to the lowest possible dose, and, if possible, to stop them. Most people are counseled to keep taking Plaquenil long after the disease is quiet. Non-steroidal anti-inflammatory medicines such as ibuprofen, Celebrex®, naproxen (Naprosyn®), etc. should be stopped if there is no pain. Immunosuppressant medicines (such as methotrexate or Imuran®) can sometimes be decreased little by little, but this all depends upon the exact history of the individual’s disease. 

Medically reviewed on July 18, 2013