The clinically quiescent phase in early-diagnosed SLE patients: inception cohort study

Rheumatology (Oxford). 2015 May;54(5):868-75. doi: 10.1093/rheumatology/keu406. Epub 2014 Oct 21.


Objectives: The aims of this study were to evaluate the incidence of clinical quiescence in early-diagnosed SLE patients and to determine factors associated with a prolonged clinically quiescent phase.

Methods: We used an inception cohort of SLE patients seen between May 2007 and June 2012. All patients were assessed for clinical quiescence [modified SLEDAI 2000 (mSLEDAI-2K) score = 0, no new features of lupus activity o increase in treatment] then evaluated for the occurrence of flare (mSLEDAI-2K increase ≥4 and increased disease activity in one or more organ systems or an increase in treatment).

Results: Ninety-five patients (88 females) with a mean age of 33.22 years (s.d. 13.24) and mean disease duration 2.79 months (s.d. 3.19) at cohort entry were enrolled during a mean observation period of 3.04 years (s.d. 1.38). Sixty-six patients (69.5%) reached clinical quiescence within 11.31 months (s.d. 1.10) of enrolment. Thirty-six patients (54.5%) had a disease flare during the observation period. The clinically quiescent phase was 28.2 months (s.d. 3.4). Cox regression analysis revealed that age ≥25 years at diagnosis [hazard ratio (HR) 2.57 (95% CI 1.23, 5.40)] and continued antimalarial drug treatment [HR 2.80 (95% CI 1.40, 5.58)] were associated with a longer clinically quiescent phase.

Conclusion: Most early-diagnosed SLE patients could have a good prognosis. Age at diagnosis ≥25 years or continued treatment with antimalarial drugs after reaching clinical quiescence may result in a longer clinically quiescent phase. More studies are needed to elucidate the mechanism of action for these protective effects.

Keywords: SLE; antimalarial drugs; clinically quiescence; early-diagnosed; flare; remission.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antimalarials / therapeutic use*
  • Cohort Studies
  • Disease Progression*
  • Dose-Response Relationship, Drug
  • Early Diagnosis*
  • Female
  • Humans
  • Lupus Erythematosus, Systemic / diagnosis*
  • Lupus Erythematosus, Systemic / drug therapy*
  • Male
  • Middle Aged
  • Prognosis
  • Regression Analysis
  • Retrospective Studies
  • Secondary Prevention
  • Severity of Illness Index*
  • Time Factors
  • Treatment Outcome


  • Antimalarials