{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T16:15:14Z","timestamp":1776356114487,"version":"3.51.2"},"reference-count":22,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2022,9,27]],"date-time":"2022-09-27T00:00:00Z","timestamp":1664236800000},"content-version":"unspecified","delay-in-days":26,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["KAKENHI Grant Number JP19K1053"],"award-info":[{"award-number":["KAKENHI Grant Number JP19K1053"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Lupus Sci Med"],"accepted":{"date-parts":[[2022,9,18]]},"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>It is still unclear how glucocorticoids (GCs) affect the long-term clinical course of patients with SLE. The objective of this study is to explore the factors associated with GC-free treatment status.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Using data from the lupus registry of nationwide institutions, GC dose at registration was compared between short, middle and long disease durations of &lt;5, 5\u201320 and \u226520 years, respectively. After excluding patients who never used GC, we evaluated the relationship between GC-free status and chronic damage using Systemic Lupus International Collaborating Clinics Damage Index.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>GC doses at enrolment of the 1019 patients were as follows: GC-free in 101 (10%); 0&lt;prednisolone (PSL) \u22645\u2009mg\/day in 411 (40%); 5&lt;PSL \u22647.5 in 169 (17%); 7.5&lt;PSL \u226410 in 194 (19%) and PSL\u226510 in 144 (14%) patients. Of the patients who were not currently using GCs, patients who never used GC more frequently had short disease duration (66% with short, 23% with middle and 17% with long disease duration, p=0.00029). Univariate analysis of patients who underwent GC treatment showed that patients without GCs exhibited older age, lower disease activity, less immunosuppressant and hydroxychloroquine use and higher C3 levels. Among patients with a disease duration of \u226520 years, GC-free status was more frequent in patients without chronic damage (11% vs 4%, p=0.023). After adjusting for age, sex and disease activity, no chronic damage accrual was associated with GC-free status (OR 3.6, 95% CI 1.1 to 11.3).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Even in the patients with long disease duration, one-point GC-free treatment status might be related to no chronic damage accrual.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/lupus-2022-000772","type":"journal-article","created":{"date-parts":[[2022,9,27]],"date-time":"2022-09-27T12:54:35Z","timestamp":1664283275000},"page":"e000772","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Association of one-point glucocorticoid-free status with chronic damage and disease duration in systemic lupus erythematosus: a cross-sectional study"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1020-0818","authenticated-orcid":false,"given":"Ken-ei","family":"Sada","sequence":"first","affiliation":[{"name":"Department of Clinical Epidemiology, Kochi Medical School, Nankoku, Japan"},{"name":"Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6192-9855","authenticated-orcid":false,"given":"Yu","family":"Katayama","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yosuke","family":"Asano","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keigo","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshia","family":"Miyawaki","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keiji","family":"Ohashi","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eri","family":"Katsuyama","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takayuki","family":"Katsuyama","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariko","family":"Takano-Narazaki","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshinori","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryusuke","family":"Yoshimi","sequence":"additional","affiliation":[{"name":"Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuhiro","family":"Shimojima","sequence":"additional","affiliation":[{"name":"Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Matsumoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shigeru","family":"Ohno","sequence":"additional","affiliation":[{"name":"Center for Rheumatic Diseases, Yokohama City University Medical Center, Yokohama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Kajiyama","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Applied Immunology, Faculty of Medicine, Saitama Medical University, Saitama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kunihiro","family":"Ichinose","sequence":"additional","affiliation":[{"name":"Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuzo","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Fukushima Medical University School of Medicine, Fukushima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michio","family":"Fujiwara","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Yokohama Rosai Hospital, Yokohama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobuyuki","family":"Yajima","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan"},{"name":"Center for Innovative Research for Communities and Clinical Excellence, Fukushima Medical University, Fukushima, Japan"},{"name":"Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, 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chronic organ damage and worsens disease outcome in systemic lupus erythematosus","volume":"36","author":"Tarr","year":"2017","journal-title":"Clin Rheumatol"},{"key":"2025091512332437000_9.1.e000772.16","doi-asserted-by":"publisher","DOI":"10.1177\/0961203318817132"},{"key":"2025091512332437000_9.1.e000772.17","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2008.094763"},{"key":"2025091512332437000_9.1.e000772.18","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780400928"},{"key":"2025091512332437000_9.1.e000772.19","first-page":"288","article-title":"Systemic lupus erythematosus disease activity index 2000","volume":"29","author":"Gladman","year":"2002","journal-title":"J Rheumatol"},{"key":"2025091512332437000_9.1.e000772.20","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780390303"},{"key":"2025091512332437000_9.1.e000772.21","doi-asserted-by":"crossref","DOI":"10.3390\/jcm11123368","article-title":"The impacts of the clinical and genetic factors on chronic damage in Caucasian systemic lupus erythematosus patients","volume":"11","author":"Ceccarelli","year":"2022","journal-title":"J Clin Med"},{"key":"2025091512332437000_9.1.e000772.22","doi-asserted-by":"publisher","DOI":"10.1136\/lupus-2020-000398"}],"container-title":["Lupus Science &amp; 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