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Edited by Yimaitong, please do not reprint without authorization
.
On August 18th, the journal Ann Rheum Dis.
(impact factor 19.
103) published an article, deriving and verifying the threshold of clinical remission and activity classification in SLE patients based on the “new standard” Systemic Lupus Erythematosus Disease Activity Score (SLE-DAS) Value, and developed and tested a SLE-DAS online calculation method (http://sle-das.
eu/)
.
SLE-DAS includes important disease activity characteristics that SLEDAI-2000 does not have.
Compared with SLEDAI-2000, it has a higher predictive value for injury progression
.
The treatment of systemic lupus erythematosus (SLE) aims at achieving clinical remission or low disease activity, and stratifies patients according to different disease activities
.
The SLE Disease Activity Index (SLEDAI-2000) scoring standard and the British Isles Lupus Assessment Group Index (BILAG-2004) are commonly used clinical evaluation standards in China
.
However, SLEDAI-2000 has limitations in accurately defining clinical remission and disease activity.
For this reason, the clinical application needs to be combined with the clinician’s overall judgment (PGA) for a comprehensive evaluation; BILAG-2004 is not as time-consuming as the evaluation.
Reflect the problem of the patient’s disease activity status when visiting a doctor
.
For this reason, a new evaluation standard-SLE-DAS, came into being
.
What is SLE-DAS? SLE-DAS is a comprehensive index with continuous measurement properties, including important disease activity characteristics not found in SLEDAI-2000.
Compared with SLEDAI-2000, it has a higher predictive value for injury progression
.
SLE-DAS contains 17 weighted clinical and laboratory indicators, including continuous measurement of arthritis, proteinuria, thrombocytopenia, and leukopenia.
Other items are scored using a two-point system (0/1 points)
.
Importantly, SLE-DAS includes rare but important SLE manifestations that SLEDAI lacks, such as eye involvement, heart/lung involvement, gastrointestinal manifestations, and hemolytic anemia (Table 1)
.
Table 1 SLE-DAS rules and descriptions are based on SLE-DAS.
How is SLE classified? The study included 1190 SLE patients: 221 in the deduction cohort and 969 in the verification cohort (150 from the Cochin study; 819 from the BLISS-76 study)
.
Based on the derived cohort, the critical value of SLE disease activity is: remission: SLE-DAS≤2.
08; mild: 2.
08<SLE-DAS≤7.
64; moderate/severe: SLE-DAS>7.
64; according to the verification of the Cochin cohort , The sensitivity and specificity of the three cut-off values are high, and the sensitivity and specificity of alleviation are higher than 95% (Table 2)
.
At the same time, the evaluation results are consistent with the expert's clinical judgment and BILAG index
.
Table 2 Sensitivity and specificity of the three cut-off values.
In addition, regarding clinical remission, the study drew two criteria based on Boolean and index respectively: SLE-DAS=0, prednisone dose ≤5mg/d; SLE-DAS≤ 2.
08, prednisone dose ≤5mg/d
.
It has been verified that the sensitivity of the two SLE clinical remission criteria based on Boolean and index is 100%, and the specificity is more than 97%
.
Summary SLE-DAS is an accurate and easy-to-use tool that can be used to assess the clinical remission status and disease activity of SLE patients
.
The study derives and validates the critical values of SLE-DAS scores for remission, mild, and moderate/severe disease activity.
These definitions can provide guidance for clinicians to implement standard treatments and adjust treatment plans based on the patient’s disease activity level with the help of SLE-DAS scores
.
SLE-DAS includes important disease activity characteristics that SLEDAI-2000 does not have, such as eye involvement, heart/lung involvement, gastrointestinal manifestations, and hemolytic anemia.
It has a higher predictive value for the progression of patients’ injury.
It will be applied to the clinic as soon as possible to provide a more comprehensive SLE classification method for the clinic
.
References: 1.
Jesus D, Matos A, Henriques C, et al.
Derivation and validation of the SLE Disease Activity Score (SLE-DAS): a new SLE continuous measure with high sensitivity for changes in disease activity[J].
Ann Rheum Dis.
2019 Mar;78(3):365-371.
2.
Jesus D, Larosa M, Henriques C,et al.
Systemic Lupus Erythematosus Disease Activity Score (SLE-DAS) enables accurate and user-friendly definitions of clinical remission and categories of disease activity[J].
Ann Rheum Dis.
2021 Aug 18:annrheumdis-2021-220363.
.
On August 18th, the journal Ann Rheum Dis.
(impact factor 19.
103) published an article, deriving and verifying the threshold of clinical remission and activity classification in SLE patients based on the “new standard” Systemic Lupus Erythematosus Disease Activity Score (SLE-DAS) Value, and developed and tested a SLE-DAS online calculation method (http://sle-das.
eu/)
.
SLE-DAS includes important disease activity characteristics that SLEDAI-2000 does not have.
Compared with SLEDAI-2000, it has a higher predictive value for injury progression
.
The treatment of systemic lupus erythematosus (SLE) aims at achieving clinical remission or low disease activity, and stratifies patients according to different disease activities
.
The SLE Disease Activity Index (SLEDAI-2000) scoring standard and the British Isles Lupus Assessment Group Index (BILAG-2004) are commonly used clinical evaluation standards in China
.
However, SLEDAI-2000 has limitations in accurately defining clinical remission and disease activity.
For this reason, the clinical application needs to be combined with the clinician’s overall judgment (PGA) for a comprehensive evaluation; BILAG-2004 is not as time-consuming as the evaluation.
Reflect the problem of the patient’s disease activity status when visiting a doctor
.
For this reason, a new evaluation standard-SLE-DAS, came into being
.
What is SLE-DAS? SLE-DAS is a comprehensive index with continuous measurement properties, including important disease activity characteristics not found in SLEDAI-2000.
Compared with SLEDAI-2000, it has a higher predictive value for injury progression
.
SLE-DAS contains 17 weighted clinical and laboratory indicators, including continuous measurement of arthritis, proteinuria, thrombocytopenia, and leukopenia.
Other items are scored using a two-point system (0/1 points)
.
Importantly, SLE-DAS includes rare but important SLE manifestations that SLEDAI lacks, such as eye involvement, heart/lung involvement, gastrointestinal manifestations, and hemolytic anemia (Table 1)
.
Table 1 SLE-DAS rules and descriptions are based on SLE-DAS.
How is SLE classified? The study included 1190 SLE patients: 221 in the deduction cohort and 969 in the verification cohort (150 from the Cochin study; 819 from the BLISS-76 study)
.
Based on the derived cohort, the critical value of SLE disease activity is: remission: SLE-DAS≤2.
08; mild: 2.
08<SLE-DAS≤7.
64; moderate/severe: SLE-DAS>7.
64; according to the verification of the Cochin cohort , The sensitivity and specificity of the three cut-off values are high, and the sensitivity and specificity of alleviation are higher than 95% (Table 2)
.
At the same time, the evaluation results are consistent with the expert's clinical judgment and BILAG index
.
Table 2 Sensitivity and specificity of the three cut-off values.
In addition, regarding clinical remission, the study drew two criteria based on Boolean and index respectively: SLE-DAS=0, prednisone dose ≤5mg/d; SLE-DAS≤ 2.
08, prednisone dose ≤5mg/d
.
It has been verified that the sensitivity of the two SLE clinical remission criteria based on Boolean and index is 100%, and the specificity is more than 97%
.
Summary SLE-DAS is an accurate and easy-to-use tool that can be used to assess the clinical remission status and disease activity of SLE patients
.
The study derives and validates the critical values of SLE-DAS scores for remission, mild, and moderate/severe disease activity.
These definitions can provide guidance for clinicians to implement standard treatments and adjust treatment plans based on the patient’s disease activity level with the help of SLE-DAS scores
.
SLE-DAS includes important disease activity characteristics that SLEDAI-2000 does not have, such as eye involvement, heart/lung involvement, gastrointestinal manifestations, and hemolytic anemia.
It has a higher predictive value for the progression of patients’ injury.
It will be applied to the clinic as soon as possible to provide a more comprehensive SLE classification method for the clinic
.
References: 1.
Jesus D, Matos A, Henriques C, et al.
Derivation and validation of the SLE Disease Activity Score (SLE-DAS): a new SLE continuous measure with high sensitivity for changes in disease activity[J].
Ann Rheum Dis.
2019 Mar;78(3):365-371.
2.
Jesus D, Larosa M, Henriques C,et al.
Systemic Lupus Erythematosus Disease Activity Score (SLE-DAS) enables accurate and user-friendly definitions of clinical remission and categories of disease activity[J].
Ann Rheum Dis.
2021 Aug 18:annrheumdis-2021-220363.
