Trends and variability in the use of glucocorticoids in patients with systemic lupus erythematosus included in the RELESSER-PROS registry

Context Recommendations for the management of systemic lupus erythematosus (SLE) advocate increasingly restrictive use of glucocorticoids (GC). However, there are no wide-scale data on their use in clinical practice from Spain, nor on compliance with current recommendations. The objective was to analyse this aspect of SLE treatment by autonomous communities (AC).Methods Observational, descriptive, longitudinal, and prospective study of patients with SLE included in RELESSER-PROS regarding patterns of GC use.Results 1432 patients were included, 89.8% women, mean age 56 years (±13.6), median follow-up 3.80 [2.06, 4.18] years, from 2015 to 2021. Median S-SLEDAI (5 visits): 2.00 [Q-Q3] [0-4.00], PGA: 0.3 [0, 0.9]. Median SLICC/ARC DI: 0 [0-1.00], mean: 0.83 (±1.20). Between 30% and 61% of patients received GC at baseline and between 17% and 50% at the end (V5). A progressive decrease in the percentage of patients receiving GC was observed in most AC, reaching the minimum at V5. Between 71.45% and 89.47% of patients, by autonomous community, met the criterion of ≤5 mg of prednisone at V5, with a delta between the autonomous community with the highest percentage and the lowest of 18 points. This percentage increased between visit 1 and visit 5 in all cases.Conclusions The use of low-dose GCs is common in Spanish lupus patients, although there is a clear downward trend in their use. Most patients typically reach the recommended dose. There are differences between the different autonomous communities in the use of GCs and their dosage.