Adjuvant Molecular Hydrogen Facilitates Immunosuppressant Tapering and Sustained Remission in Systemic Lupus Erythematosus: A Case Report

BACKGROUND/AIM: ), a selective antioxidant with anti-inflammatory properties, may serve as an adjunct therapy, potentially maintaining disease control while reducing immunosuppressive burden. CASE REPORT: capsule therapy was initiated as an adjunct. The patient exhibited rapid and robust serologic improvement, allowing for the complete discontinuation of mycophenolic acid within one month. Over an extended follow-up through early 2026, her regimen was successfully de-escalated to a minimized monotherapy of prednisolone 10 mg/day. Her anti-dsDNA levels stabilized within a strictly normal range (<15 IU/ml), with normalized complement levels, no further infections, and profoundly reduced fatigue. Flow-cytometric profiling revealed a coordinated reprogramming of adaptive immunity toward a controlled, non-senescent state, including a homeostatic reset in the B-cell compartment and decreased active-disease-associated T cells. CONCLUSION: Adjuvant molecular hydrogen therapy stabilized active SLE, enabling substantial reduction of conventional immunosuppressants while maintaining durable clinical and serologic remission. This strategy may represent a promising immunosuppressant-sparing approach and warrants validation in controlled trials.