Gizem VARKAL, Gül Şahika GÖKDEMİR
Rheumatology Quarterly - 2026;4(3):164-171
Objective: To identify clinical factors associated with aggressive treatment history and current and cumulative treatment burden in systemic lupus erythematosus (SLE). Methods: This retrospective cross-sectional study included 103 adults with SLE. Aggressive treatment was defined as previous or current use of cyclophosphamide, mycophenolate mofetil, or rituximab. Current and cumulative treatment burden were assessed by the number of disease-modifying therapies. Multivariable binary and ordinal logistic regression analyses were performed. Results: Thirty-one patients (30.1%) had received aggressive treatment. Major organ involvement was independently associated with aggressive treatment history and greater current and cumulative treatment burden (all P < .001). Higher Systemic Lupus Erythematosus Disease Activity Index-2000 scores were associated with aggressive treatment history (OR 1.41, 95% CI: 1.04-1.92) and current treatment burden (OR 1.32, 95% CI: 1.09-1.61). Longer disease duration was associated with aggressive treatment history (OR 1.19, 95% CI: 1.01-1.39) and cumulative treatment burden (OR 1.13, 95% CI: 1.03-1.23), while younger age was associated with cumulative treatment burden (OR 0.96, 95% CI: 0.93-1.00). Conclusion: Although major organ involvement was the factor most strongly associated with treatment escalation, disease activity, disease duration, and age also contributed to treatment heterogeneity in SLE.
