Predictors of flares and long-term outcome of systemic lupus erythematosus during combined treatment with azathioprine and low-dose prednisolone

Rheumatol Int. 1996;16(4):133-9. doi: 10.1007/BF01419725.


Many patients with systemic lupus erythematosus (SLE) receive long-term treatment with azathioprine and prednisolone to control disease activity. In a retrospective study we evaluated the efficacy of combined treatment with azathioprine (2 mg/kg body weight/d) and low-dose prednisolone (7-12 mg/d) and the predictors of disease flares during this therapy regimen in 61 patients with SLE. We found three predictors of flares: renal disease, persistence of dsDNA antibodies for at least 1 year after the beginning of treatment and reduction in azathioprine dosage to below 2 mg/kg/d. The occurrence of flares was significantly associated with a higher rate of disease-related death. Furthermore, the persistence of dsDNA antibodies for at least 2 years was associated with progression of renal disease. We concluded that suppression of production of dsDNA antibodies with high avidity is a suitable parameter to determine efficacy of treatment and long-term outcome during combined therapy with azathioprine and low-dose prednisolone in SLE.

MeSH terms

  • Adolescent
  • Adult
  • Antirheumatic Agents / therapeutic use*
  • Azathioprine / therapeutic use*
  • Child
  • Drug Therapy, Combination
  • Female
  • Humans
  • Lupus Erythematosus, Systemic / drug therapy*
  • Lupus Erythematosus, Systemic / physiopathology
  • Male
  • Middle Aged
  • Prednisolone / therapeutic use*
  • Prognosis
  • Retrospective Studies


  • Antirheumatic Agents
  • Prednisolone
  • Azathioprine