ABSTRACT Objectives To assess treatment patterns for systemic lupus erythematosus (SLE) from 2012 to 2024 and evaluate corresponding changes in serological activity and relapse rates. Methods We retrospectively reviewed medical records of 1,705 patients with SLE treated at a single centre between 2012 and 2024. Temporal trends in therapeutic approaches, glucocorticoid (GC) use, and clinical outcomes were analysed. Results Use of GC monotherapy declined from 58.3% in 2012 to 22.4% in 2024. Combination therapies (GC and hydroxychloroquine HCQ, with or without immunosuppressants) increased from 1.0% in 2015 to 41.6% in 2024, while biologics use rose from 0.9% in 2018 to 12.5% in 2024. Quadruple therapy (GC, HCQ, immunosuppressants, and biologics) also expanded from 0.4% in 2018 to 6.2% in 2024. The mean GC dose decreased from 7.7 mg/day in 2012 to 4.6 mg/day in 2024, and the median dose, stable at 5 mg/day for many years, declined to 4.6 mg in 2023 and 4.2 mg in 2024. The proportion of patients with elevated serological activity steadily decreased. Flare rates peaked at 8.1% in 2016 but stabilised at approximately 4% after 2020. Conclusions These findings suggest that improved disease control can increasingly be achieved in real-world practice while reducing long-term GC dependence.
Minowa et al. (Tue,) studied this question.