Definition and initial validation of a Lupus Low Disease Activity State (LLDAS)
| Autor: | O Jin, Eric F Morand, Chak Sing Lau, Sandra V. Navarra, Molla Huq, Worawit Louthrenoo, Mandana Nikpour, Alberta Hoi, Kate Franklyn, Aisha Lateef, C Singgih Wahono, Laniyati Hamijoyo, S. Morton, Shun Le Chen |
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| Rok vydání: | 2015 |
| Předmět: |
0301 basic medicine
Adult Male Risk medicine.medical_specialty Time Factors Immunology Risk Assessment Severity of Illness Index General Biochemistry Genetics and Molecular Biology 03 medical and health sciences 0302 clinical medicine Rheumatology Internal medicine Severity of illness medicine Immunology and Allergy Humans Lupus Erythematosus Systemic skin and connective tissue diseases 030203 arthritis & rheumatology Systemic lupus erythematosus Lupus erythematosus business.industry Reproducibility of Results Middle Aged medicine.disease Connective tissue disease 030104 developmental biology Rheumatoid arthritis Cohort Prednisolone Female business medicine.drug |
| Zdroj: | Annals of the rheumatic diseases. 75(9) |
| ISSN: | 1468-2060 |
| Popis: | AimsTreating to low disease activity is routine in rheumatoid arthritis, but no comparable goal has been defined for systemic lupus erythematosus (SLE). We sought to define and validate a Lupus Low Disease Activity State (LLDAS).MethodsA consensus definition of LLDAS was generated using Delphi and nominal group techniques. Criterion validity was determined by measuring the ability of LLDAS attainment, in a single-centre SLE cohort, to predict non-accrual of irreversible organ damage, measured using the Systemic Lupus International Collaborating Clinics Damage Index (SDI).ResultsConsensus methodology led to the following definition of LLDAS: (1) SLE Disease Activity Index (SLEDAI)-2K ≤4, with no activity in major organ systems (renal, central nervous system (CNS), cardiopulmonary, vasculitis, fever) and no haemolytic anaemia or gastrointestinal activity; (2) no new lupus disease activity compared with the previous assessment; (3) a Safety of Estrogens in Lupus Erythematosus National Assessment (SELENA)-SLEDAI physician global assessment (scale 0–3) ≤1; (4) a current prednisolone (or equivalent) dose ≤7.5 mg daily; and (5) well tolerated standard maintenance doses of immunosuppressive drugs and approved biological agents. Achievement of LLDAS was determined in 191 patients followed for a mean of 3.9 years. Patients who spent greater than 50% of their observed time in LLDAS had significantly reduced organ damage accrual compared with patients who spent less than 50% of their time in LLDAS (p=0.0007) and were significantly less likely to have an increase in SDI of ≥1 (relative risk 0.47, 95% CI 0.28 to 0.79, p=0.005).ConclusionsA definition of LLDAS has been generated, and preliminary validation demonstrates its attainment to be associated with improved outcomes in SLE. |
| Databáze: | OpenAIRE |
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