Serologically active clinically quiescent systemic lupus erythematosus--predictors of clinical flares.

OBJECTIVE: To identify the frequency of serologic activity in the face of clinical quiescence in a large cohort of patients with systemic lupus erythematosus (SLE) followed prospectively in a single center.

METHODS: In a prospective cohort study, patients serologically active but clinically quiescent (SACQ) in 3 consecutive clinic visits were analyzed for the development of a clinical flare over the subsequent year and were evaluated for predictive factors for flare before and during their SACQ period.

RESULTS: Forty-six episodes of SACQ went on to clinical flare within one year while 60 did not. No predictive factors for flare were found either during or before the SACQ period.

CONCLUSIONS: A significant population of patients with SLE are SACQ and must be followed over time and treated only on the basis of clinical criteria.