Smoking, discoid lesions prevent long-term remission in cutaneous lupus erythematosus

Very few patients with cutaneous lupus erythematosus (CLE) achieve long-term remission, which is negatively associated with active smoking and discoid CLE, reports a study.

Not much is known about the prevalence and factors associated with long-term remission in CLE. To address this, a team of investigators performed this longitudinal cohort study to assess the prevalence, factors associated with remission, and long-term remission with and without treatment during CLE.

Patients with CLE seen between 1 November 2019 and 30 April 2021, with at least 6 months of follow-up after diagnosis, were included in the analysis. The investigators recorded demographic data, CLE subtypes, remission status, and treatments.

Remission was defined as a Cutaneous Lupus Erythematosus Disease Area and Severity Index activity score of 0, while long-term remission referred to remission of >3 years.

One hundred forty-one patients (81 percent women) were included, of which 93 (66 percent) were in remission at last follow-up, with a median duration since diagnosis of 11.4 years (interquartile range, 4.2‒24.7). Twenty-two of 114 patients with at least 3 years of follow-up achieved long-term remission, of which five (4.4 percent) received no systemic treatment.

Factors such as active smoking (odds ratio [OR], 0.22, 95 percent confidence interval [CI], 0.05‒0.97; p=0.04) and discoid CLE lesions (OR, 0.14, 95 percent CI, 0.04‒0.48; p=0.004) contributed to a reduced likelihood of long-term remission.

This study was limited by its partial retrospective data collection and tertiary centre population, according to the investigators.