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Title: A framework for remission in SLE: consensus findings from a large international task force on definitions of remission in SLE (DORIS)
Author: Van Vollenhoven, Ronald F.
Voskuyl, Alexandre E.
Bertsias, George
Aranow, Cynthia
Aringer, Martin
Arnaud, Laurent
Askanase, Anca
Balá ová, Petra
Bonfa, Eloisa
Bootsma, Hendrika
Boumpas, Dimitrios
Bruce, Ian N.
Cervera i Segura, Ricard, 1960-
Clarke, Ann E.
Coney, Cindy
Costedoat-Chalumeau, Nathalie
Czirják, László
Derksen, R. H. W. M.
Doria, Andrea
Dörner, Thomas
Fischer-Betz, Rebecca
Fritsch-Stork, Ruth
Gordon, Caroline
Graninger, Winfried
Györi, Noémi
Houssiau, Frédéric A.
Isenberg, David
Jacobsen, Søren
Jayne, David
Kuhn, Annegret
Le Guern, Véronique
Lerstrøm, Kirsten
Levy, Roger A.
Machado-Ribeiro, Francinne
Mariette, Xavier
Missaykeh, Jamil
Morand, Eric
Mosca, Marta
Inanc, Murat
Navarra, Sandra
Keywords: Lupus eritematós
Malalties autoimmunitàries
Estudi de casos
Lupus erythematosus
Autoimmune diseases
Case studies
Issue Date: 24-Nov-2016
Publisher: BMJ Publishing Group
Abstract: Objectives Treat-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. Methods An 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%. Results The 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. Conclusions The work of this international task force provides a framework for testing different definitions of remission against long-term outcomes.
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It is part of: Annals of the Rheumatic Diseases, 2016, vol. 76, num. 3, p. 554-561
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ISSN: 0003-4967
Appears in Collections:Articles publicats en revistes (Medicina)

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