Total Discontinuation of Prednisone is Achievable in Lupus Remission

Research shows discontinuing treatment with glucocorticoids (e.g., prednisone) – one of the main goals of lupus management – is achievable in lupus remission. Though, some people are better candidates for complete prednisone withdrawal than others. According to a new study, those with a long-term history remission and hydroxychloroquine (HCQ) therapy are most likely to successfully stop prednisone use.

In the study, 56 people who had been in lupus remission for two or more years and on stable lupus treatment, including 5 mg of prednisone daily, attempted to stop their prednisone regimen. While those in the prednisone withdrawal group did not experience significantly more flares than those who maintained their prednisone therapy, some people had better outcomes than others when stopping the treatment.

A history of lupus remission for at least five years and long-term HCQ treatment were associated with lower risk of flares after discontinuing prednisone, whereas a history of lupus nephritis (lupus-related kidney disease) increased flare risk. Additionally, people who were considered “serologically active” – having blood test results showing lupus disease activity – despite having no clinical signs or symptoms, were also more likely to have flares upon prednisone withdrawal.

The findings underscore that ultimately ending prednisone therapy is an achievable goal for people with lupus in complete remission. Although prednisone is a very effective anti-inflammatory drug for lupus treatment, it can have significant side effects. Recent research has also found that prednisone is linked to poor emotional health in people with low lupus disease activity, even at low doses.

Consult your physician before making any changes to your medication.

Read the study