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RESEARCH PRODUCT
A framework for remission in SLE
Marzena OlesińskaRonald H. W. M. DerksenJamil MissaykehEloisa BonfaAnne VossMarta MoscaOle Petter RekvigMartin AringerMurray B. UrowitzLaurent ArnaudSandra V. NavarraAsad ZomaRuth D E Fritsch-storkCaroline GordonVictoria P. WerthDavid A. IsenbergAlexandre E. VoskuylJosef S SmolenJozef RovenskyCynthia AranowNathalie Costedoat-chalumeauVéronique Le GuernRoger A. LevyRonald F Van VollenhovenAnnegret KuhnGeorge BertsiasXavier MarietteThomas DörnerHendrika BootsmaKirsten LerstrømAnn E. ClarkeRebecca Fischer-betzLászló CzirjákLászló CzirjákPetra BalážováBernadette Van LeeuwN. GyöriMurat InancMichelle PetriIan N. BruceRicard CerveraDimitrios T. BoumpasAngela TincaniWinfried GraningerFrancinne Machado-ribeiroCindy ConeySøren JacobsenDavid JayneAnisur RahmanCarlos VasconcelosYehuda ShoenfeldFrédéric HoussiauEric F MorandIrmgard NeumannHelena ZakharovaAnca AskanaseAndrea DoriaMatthias SchneiderMichael E. Wardsubject
Genetics and Molecular Biology (all)PediatricsAutoimmune diseasesNEPHRITIS PATIENTSDISEASE-ACTIVITYSeverity of Illness IndexBiochemistryRETROSPECTIVE ANALYSIS0302 clinical medicineQuality of lifePrednisoneAdrenal Cortex HormonesLupus Erythematosus SystemicImmunology and AllergyCHINESE PATIENTS030212 general & internal medicineSYSTEMIC-LUPUS-ERYTHEMATOSUSskin and connective tissue diseasesPREDICTORSOUTCOMESSystemic lupus erythematosusMalalties autoimmunitàriesRemission InductionSYSTEMIC-LUPUS-ERYTHEMATOSUS; DISEASE-ACTIVITY; RETROSPECTIVE ANALYSIS; INITIAL VALIDATION; NEPHRITIS PATIENTS; AMERICAN-COLLEGE; CHINESE PATIENTS; RENAL FLARES; PREDICTORS; OUTCOMESSymptom Flare UpConnective tissue diseaseManchester Institute for Collaborative Research on AgeingEstudi de casosOutcomes researchAntibodies AntinuclearDNA/immunologyImmunosuppressive Agentsmedicine.drugmedicine.medical_specialtyFarmacologiaResearchInstitutes_Networks_Beacons/MICRAConsensusImmunologyAdrenal Cortex Hormones/therapeutic useAMERICAN-COLLEGELupus Erythematosus Systemic/bloodSystemic Lupus ErythematosusGeneral Biochemistry Genetics and Molecular BiologyMaintenance Chemotherapy03 medical and health sciencesAntimalarialsRheumatologySeverity of illnessmedicineDisease Activity; Outcomes research; Systemic Lupus Erythematosus; Immunology and Allergy; Rheumatology; Immunology; Biochemistry Genetics and Molecular Biology (all)HumansDisease Activity030203 arthritis & rheumatologyPharmacologyAntibodies Antinuclear/bloodLupus erythematosusbusiness.industryTask forceConstruct validityRENAL FLARESComplement System ProteinsDNAINITIAL VALIDATIONDisease Activity; Outcomes research; Systemic Lupus Erythematosusmedicine.diseaseLupus eritematósAntimalarials/therapeutic usePhysical therapyImmunosuppressive Agents/therapeutic useComplement System Proteins/metabolismCase studiesOutcomes researchbusinessdescription
ObjectivesTreat-to-target recommendations have identified ‘remission’ as a target in systemic lupus erythematosus (SLE), but recognise that there is no universally accepted definition for this. Therefore, we initiated a process to achieve consensus on potential definitions for remission in SLE.MethodsAn international task force of 60 specialists and patient representatives participated in preparatory exercises, a face-to-face meeting and follow-up electronic voting. The level for agreement was set at 90%.ResultsThe task force agreed on eight key statements regarding remission in SLE and three principles to guide the further development of remission definitions:1. Definitions of remission will be worded as follows: remission in SLE is a durable state characterised by …………………. (reference to symptoms, signs, routine labs).2. For defining remission, a validated index must be used, for example, clinical systemic lupus erythematosus disease activity index (SLEDAI)=0, British Isles lupus assessment group (BILAG) 2004 D/E only, clinical European consensus lupus outcome measure (ECLAM)=0; with routine laboratory assessments included, and supplemented with physician's global assessment.3. Distinction is made between remission off and on therapy: remission off therapy requires the patient to be on no other treatment for SLE than maintenance antimalarials; and remission on therapy allows patients to be on stable maintenance antimalarials, low-dose corticosteroids (prednisone ≤5 mg/day), maintenance immunosuppressives and/or maintenance biologics.The task force also agreed that the most appropriate outcomes (dependent variables) for testing the prognostic value (construct validity) of potential remission definitions are: death, damage, flares and measures of health-related quality of life.ConclusionsThe work of this international task force provides a framework for testing different definitions of remission against long-term outcomes.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2017-03-01 | Annals of the Rheumatic Diseases |