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LN Maintenance Duration — SCE Rheumatology MCQ

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ModerateSLE & Antiphospholipid SyndromeLN Maintenance DurationSCE Rheumatology

A 48-year-old woman with SLE and lupus nephritis has been in complete renal remission for 4 years on Mycophenolate and Hydroxychloroquine. According to EULAR 2023 when can immunosuppressive tapering be considered?

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Correct answer: B — After at least 3 years of maintenance therapy with sustained remission

EULAR 2023 recommends maintaining immunosuppressive treatment for lupus nephritis for at least 3 years before considering tapering. This patient has completed 4 years and may be a candidate for cautious dose reduction. Repeated renal biopsy may help guide the decision if histological quiescence is confirmed. Serological markers (anti-dsDNA complement) and proteinuria should be stable. Tapering should be gradual with close monitoring. Hydroxychloroquine should be continued indefinitely. Risk of relapse exists even after prolonged remission.

Reference: EULAR 2023 SLE recommendations