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SLE Steroid Target — SCE Rheumatology MCQ

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EasySLE & Antiphospholipid SyndromeSLE Steroid TargetSCE Rheumatology

A 48-year-old woman with SLE has been on Prednisolone 5 mg daily for 3 years. According to EULAR 2023 what is the maintenance glucocorticoid target?

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Correct answer: BEULAR 2023 recommends minimising glucocorticoids to ≤5 mg/day Prednisolone equivalent and ideally withdrawing glucocorticoids entirely

EULAR 2023 SLE recommendations set a clear glucocorticoid target: maintenance Prednisolone should be ≤5 mg/day (7.5 mg/day maximum) and ideally glucocorticoids should be withdrawn entirely. Even low-dose Prednisolone (5-7.5 mg daily) is associated with cumulative damage (osteoporosis diabetes cataracts cardiovascular disease avascular necrosis infections weight gain). The emphasis on glucocorticoid minimisation is one of the central themes of EULAR 2023 driving the recommendation for earlier biologic use (Belimumab Anifrolumab) without requiring prior csDMARD failure. Hydroxychloroquine independently facilitates glucocorticoid reduction and should be continued indefinitely.

Reference: EULAR 2023 SLE recommendations