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Abstract
Background Systemic lupus erythematosus (SLE) is a heterogeneous chronic autoimmune rheumatic disease characterized by a hyperproduction of autoantibodies to nuclear antigens and a wide spectrum of clinical manifestations. SLE Disease Activity Index-2000 (SLEDAI-2k) and SLE-disease activity state (SLE-DAS) are currently used to assess the activity of SLE. SLE-DAS covers a greater number of clinical manifestations of SLE, and it includes Coombs-positive hemolytic anemia, Liebman-Sachs endocarditis, the variability of vasculitis. Achieving definition of remission in SLE (DORIS) or lupus low disease activity state (LLDAS) is the main goal of therapy for patients with SLE. The aim of the study was to compare the activity of SLEDAI and SLE-DAS and to identify the correspondence of DORIS and LLDAS in SLE-DAS.
Methods The study included 228 patients with SLE (204 women and 24 men). The age was Me=36.0 [28.0–45.0] y.o. and the disease duration – Me=6.0 [2.0–14.0] years. All patients were assessed for disease activity using the activity indices – SLEDAI-2k and SLE-DAS.
Results Patients were divided into 5 groups according to SLEDAI-2K (table 1). The medians of SLEDAI-2K and SLE-DAS were comparable, but the allocation of degrees of activity for SLE-DAS is not currently envisaged.
Receiver operating characteristic (ROC) curves comparing the performance of SLE-DAS and SLEDAI-2K to detect DORIS и LLDAS are shown in (figure 1)
Conclusions Remission of SLE by DORIS corresponded to SLE-DAS≤1.1 points, for the detection of low activity, according to LLDAS, SLE-DAS was ≤2.08. In assessing the remission of SLE by DORIS, SLEDAI-2k has greater specificity (89%) compared to SLE-DAS (79%), however, ROC analysis shows a good clinical informativeness of SLE-DAS (AUC=0.901). Greater specificity of SLE-DAS for LLDAS was noted (80%) compared to SLEDAI 2k (59%) with similar sensitivity (73% and 76%, respectively).
Receiver operating characteristic (ROC) curves comparing the performance of SLE-DAS and SLEDAI-2K to detect DORIS и LLDAS
SLE activity according to SLEDAI-2K and SLE-DAS.
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