Treatment patterns and outcomes in SLE: Real-world data from the Spanish SPOCS cohort

Results from an analysis of the international, multicenter, prospective, observational systemic lupus erythematosus (SLE) Prospective Observational Cohort Study (SPOCS; NCT03189875), describing disease activity, organ damage, and health-related quality of life (HRQoL) in patients with active, moderate-to-severe SLE, were published in Lupus Science & Medicine by Lozano-Rivas et al. This analysis focused on the Spanish cohort (n = 99). Disease activity was assessed using the SLE Disease Activity Index 2000 (SLEDAI-2K) and Physician’s Global Assessment (PGA).

Key data: At 6, 12, 18, 24, and 36 months, 12.6%, 5.3%, 5.8%, 12.7%, and 9.8% of patients, respectively, were in remission, with 8.6% of patients maintaining remission over time. Lupus Low Disease Activity State (LLDAS) was achieved by 23.5%, 8.0%, 15.4%, 14.3%, and 22.0% of patients at 6, 12, 18, 24, and 36 months, respectively. Median SLEDAI-2K decreased from 8 at baseline to 4 at Month 36. At baseline, 45% of patients had organ damage, with a mean Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI) score of 1.1, which increased to 1.8 by Month 36. The most frequently affected organ systems were musculoskeletal, cutaneous, neuropsychiatric, and renal. HRQoL remained persistently poor, with 60–75% of patients reporting depressive symptoms and up to 76% reporting pain or discomfort throughout follow-up.

Key learning: Sustained remission and low disease activity remain uncommon in patients with moderate-to-severe SLE in routine Spanish clinical practice, contributing to progressive organ damage and impaired HRQoL. The findings underscore the need for implementing structured treat-to-target (T2T) approaches, earlier use of effective disease-modifying therapies, and utilization of patient-reported outcomes into routine care.