Identifying a Response for the Systemic Lupus Erythematosus Disease Activity 2000 Glucocorticoid Index. Issue 9 (27th July 2021)

• Record Type: Journal Article
• Authors: Touma, Zahi; Gladman, Dafna D.; Zandy, Moe; Su, Jiandong; Anderson, Nicole; Urowitz, Murray B.
• Is Part Of: Arthritis care & research. Volume 73:Issue 9(2021)
• Page Start: 1243
• Page End: 1249
• Publication Date: 2021-07-27
• Subjects: Arthritis -- Periodicals; Rheumatism -- Periodicals; 616.72
• DOI: 10.1002/acr.24261
• Languages: English
• ISSNs: 2151-464X

Abstract

Abstract : Objective: To compare the performance of the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI‐2K) and the SLEDAI‐2K Glucocorticoids (SLEDAI‐2KG) indices in identifying responders to standard of care therapy. Methods: Data from adult patients seen between 1995 and 2018 at the University of Toronto Lupus Clinic were analyzed. Patients with active disease (SLEDAI‐2K score ≥6) and receiving prednisone ≥5 mg/day, and with a follow‐up visit at 9 months, were studied. Response to standard of care therapy at first follow‐up visit was assessed using the SLEDAI‐2K and SLEDAI‐2KG. The performances of the SLEDAI‐2K and SLEDAI‐2KG were compared using a cutoff point of 4. Results: In a cohort of 188, the majority of patients were female (86.0%) and White (47.9%). Of 188 patients, 145 (77.1%) were responders and had a decrease in SLEDAI‐2K score of ≥4. The SLEDAI‐2KG identified 142 (97.9%) responders among the SLEDAI‐2K responders. More importantly, the SLEDAI‐2KG identified 11 (25.6%) additional responders among SLEDAI‐2K nonresponders (n = 43). This resulted from the ability of the SLEDAI‐2KG to account for the decrease in glucocorticoids dose. Conclusion: The SLEDAI‐2KG provides a novel concept for the assessment of lupus disease activity while accounting for glucocorticoids dosage to reflect on disease activity overall at a particular visit. The SLEDAI‐2KG accounts for the disease activity for each descriptor while also accounting for the current glucocorticoids dosage. The SLEDAI‐2KG adds 1 additional variable (glucocorticoids dosage) to the SLEDAI‐2K, which could alter response rates in drug trials and observational studies.