Glucocorticoid Withdrawal in Lupus Nephritis: A Study Protocol and Literature Review

Abstract

Although glucocorticoids (GCs) are the cornerstone for the treatment for systemic lupus erythematosus (SLE), they are associated with a number of adverse effects. Recently, an open randomized controlled trial (RCT) conducted in France showed that flares of SLE in 12 months were significantly more common with GCs withdrawal than continuation in stable patients. However, the study did not separately report results on subsets of SLE patients with organ threatening disease such as lupus nephritis (LN). We hereby present a literature review on GCs withdrawal in SLE and propose a protocol for a multicenter RCT in Hong Kong to evaluate the feasibility of withdrawal of low-dose GCs in stable LN patients who are in clinical remission.