Background To investigate the prevalence and level of agreement between remission according to physician and patient criteria and to evaluate the impact of remission on HRQoL in patients with SLE.
Methods Prospective study of patients included in RELESSER-PROS, a multicenter register of SLE patients, protocol previously described.1 Remission according to physician was defined in agreement with DORIS 2021 criteria.2 Remission according to patient was defined as SLAQ (Systemic Lupus Activity Questionnaire) question 1 with no flare in the last 3 months (score 0).
Patients were classified in three groups according to remission status (DORIS, SLAQ, both). Level of agreement was assessed using kappa statistics, considered acceptable if kappa>0.60.
Results 1102 patients, with a follow-up of at least 2 years (data from 3 visits available) were included. Patient characteristics according remission status at baseline are presented in the table 1. At baseline, remission by DORIS was present in 16.1%, by SLAQ 16.7% and 2.45% by both. Remission by DORIS was more frequent among patients with higher education, on immunosuppressant/biological therapy and patients with history of hospitalization; remission by SLAQ was more frequent among women, obese patients, and those on antimalarials (p<0.05). Symptoms reported in patients who considered themselves in remission were mainly cutaneous and articular (53.3%). Mean SLEDAI in patients on remission by SLAQ was 3.28 (3.78). Patients in remission by DORIS had significantly better results in patient reported outcomes measured by EQ-5D and LIT (p<0.05). Level of agreement in remission according to physician and patient was 78.04% (K=0.061) at baseline, 63.39% (K=0.039), and 62.73% (K=0.099) in year 2 and 5. Kappa level of agreement was low.
Conclusions Our results reflect low level of agreement between physician and patients in terms of remission status with increasing disagreement in the follow-up. Patients in remission by DORIS shows better results in EQ-5D and LIT.
Rúa-Figueroa I, et al. Reumatol Clin. 2014;10(1):17–24.
van Vollenhoven RF, et al. Lupus Sci Med. 2021;8(1):e000538.
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