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  • P129 Does the perspective of SLE patients match the expert opinion and definitions of remission and low disease activity state? Prospective analysis of 500 patients from a Spanish multicenter cohort

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P129 Does the perspective of SLE patients match the expert opinion and definitions of remission and low disease activity state? Prospective analysis of 500 patients from a Spanish multicenter cohort
  1. Coral Mourino Rodriguez1,2,
  2. Jose Maria Pego Reigosa1,2,
  3. Inigo Rua Figueroa3,
  4. Francisco Rubino3,
  5. Inigo Hernandez Rodriguez1,
  6. Raul Menor Almagro4,
  7. Esther Uriarte Isacelaya5,
  8. Eva Tomero Muriel6,
  9. Tarek Salman Montes7,
  10. Irene Carrion Barbera7,
  11. Maria Galindo8,
  12. Esther Rodriguez Almaraz8,
  13. Norman Jimenez2,
  14. Luis Ines9 and
  15. Irene Altabas Gonzalez1,2
  1. 1Dept. of Rheumatology, Complejo Hospitalario Universitario de Vigo. Vigo. Spain
  2. 2IRIDIS (Investigation in Rheumatology and Immune-Mediated Diseases) Group, Galicia Sur Health Research Institute. Vigo. Spain
  3. 3Dept. of Rheumatology, Hospital Universitario de Gran Canaria Dr. Negrín. Las Palmas de Gran Canaria, Spain
  4. 4Dept. of Rheumatology, Hospital Universitario de Jerez de la Frontera, Jerez de la Frontera, Spain
  5. 5Dept. of Rheumatology, Hospital Universitario de Donostia, Donostia, Spain
  6. 6Dept. of Rheumatology, Hospital Universitario de La Princesa, Madrid, Spain
  7. 7Dept. of Rheumatology, Hospital del Mar/Parc de Salut Mar-IMIM, Barcelona, Spain
  8. 8Dept. of Rheumatology, Hospital Universitario 12 de Octubre, Madrid, Spain
  9. 9Dept. of Rheumatology, Centro Hospitalar e Universitario de Coimbra, Coimbra, Portugal

Abstract

Background No data on agreement between patient perception, DORIS 2021 remission, LLDAS, or physician assessment is currently available.

The aim is to compare the SLE activity perceived by the patient using the Patient Acceptable Symptom State (PASS) question with the global assessment of activity by the physician, and the definitions of LLDAS/DORIS2021.

Methods A cross-sectional multicenter study involving SLE patients from seven Spanish Rheumatology Departments was conducted. The study applied DORIS 2021 remission criteria and LLDAS. Rheumatologists classified disease activity into five categories: remission, SACQ, low, moderate, or high. The patients were asked about their clinical SLE condition through the PASS question: ‘Considering all the different ways your disease is affecting you, if you were to stay in this state for the next few months, do you consider your current state satisfactory?’: PASS yes/PASS no. Statistical analysis included descriptive cross-sectional analysis and Cohen’s kappa for agreement analysis.

Results Among the 503 patients in the study (table 1), 386 (77.4%) reported an acceptable symptom state according to the PASS question. Mean patient global assessment (PtGA) was 29.62 (±24.38) on a scale of 0–100, while mean physician global assessment (PGA) was 0.46 (±0.59) on a scale of 0–3. A total of 236 (47.6%) patients met DORIS 2021 remission criteria, and 289 (59%) met LLDAS. According to the rheumatologists’ categorical classification, 435 (86.8%) patients were in remission or low disease activity (table 2).

Among PASS-affirmative patients, 65.5% met LLDAS and 57.9% met DORIS 2021 remission criteria, with lower PtGA (19.7) and PGA (0.29) scores. In the non-PASS group, 62.8% were not in LLDAS, and 87.6% did not meet DORIS 2021 remission criteria, with higher PtGA (58) and PGA (1) scores (table 3). The overall agreement between PASS and categorical classification was 82% with a Cohen’s kappa of 0.43.

Conclusions The majority of SLE patients reported an acceptable symptom state according to the PASS question, which aligns with the PtGA scale. Physicians’ assessments also showed similarities with patient perspectives. However, notable differences were observed regarding remission/LLDAS criteria, indicating that while patient and physician perspectives align on subjective classification, variations exist concerning LLDAS and DORIS.

View this table:
Abstract P129 Table 1

Patient demographics and disease characteristics

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Abstract P129 Table 2

SLE activity: patient and expert’s perspective

View this table:
Abstract P129 Table 3

LLDAS and DORIS 2021 remission states according to PASS yes/no perspective by patient

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ .

https://doi.org/10.1136/lupus-2024-el.183

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