Lupus & antiphospholipid syndrome
Impact of glucocorticoid dose threshold in definition of lupus low disease activity state: a multinational observational cohort study
Authors' conclusion
No evidence was found to support revising the GC dose threshold of the LLDAS definition.
Study context
- Population
- Patients with systemic lupus erythematosus (SLE) (ACR/SLICC criteria) with ≥2 visits, 13-country longitudinal cohort, 2013–2020
- Participants
- 3,072 vs 2,858
- Exposure
- Lupus low disease activity state (LLDAS) with glucocorticoid (GC) ceiling 7.5 mg/day vs LLDAS-5
- LLDASn = 3,072reference
- LLDAS-5n = 2,858
- Outcome
- Damage accrual, flare and mortality associated with LLDAS definitions
Methodological detailsmultinational (13 countries), longitudinal, survival analyses (frailty models, Cox regression)
- Multinational (13 countries)
- Longitudinal
- Survival analyses (frailty models, Cox regression)
Main finding
As reported in the abstract
Damage accrual after 12 months in sustained LLDAS / LLDAS-5
Hazard ratio (95% CI)P value
LLDAS
0.42(0.33–0.54)
P < 0.0001LLDAS-5vs LLDAS
0.43(0.34–0.55)
P < 0.001Observational data: associations, not effects.
Further findings
Attainment (visits)
- Attainment (visits) — Attained LLDAS at least once but never LLDAS-5
- 214 patients (5.6%)
Flare and mortality after 12 months in LLDAS / LLDAS-5
- HRs of flare and mortality similar for LLDAS and LLDAS-5
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Impact of glucocorticoid dose threshold in definition of lupus low disease activity state: a multinational observational cohort study. Lupus Sci Med. Published 11 November 2025. doi:10.
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