Australian experts have presented a new definition of low disease activity in SLE.
Measuring low disease activity in SLE was problematic, and although a definition of remission was published in 2007, it was met by less than 2% of patients, said Professor Eric Morand (pictured) and colleagues from Monash University in Melbourne.
“A definition of lupus low disease activity state (LLDAS) could, once validated, be applied as a novel outcome measure in observational and interventional studies,” they said.
A panel of experts from Hong Kong, China, Australia, Philippines, Thailand and Indonesia met to consider which elements should be included in a definition of low disease activity.
An expert consensus then scored each item, and following two Delphi rounds the following five items received unanimous agreement.
1. SLEDAI-2K <4, with no SLEDAI activity in major organs.
2. No new features of lupus disease activity compared to previous assessment
3. SELENA-SLEDAI physician global assessment (PGA, scale 0-3) <1
4. Current prednisolone (or equivalent) dose <7.5mg daily; and
5. Well-tolerated standard maintenance doses of immunosuppressive drugs and/or approved biologic agents.
Following 192 patients for an average of just over three years, the researchers found that LLDAS was achieved on at least one occasion by 72% of patients.
Patients who had a cumulative duration of LLDAS greater than 245 days had significantly less accrual of organ damage, the researchers found.
The definition could serve as a treatment target in SLE clinical practice, but larger studies were needed to validate the findings, they concluded.
Pfizer Immunology proudly sponsored Nicola Garret’s attendance at ACR 2013