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P181 Comparison of SLEDAI-2K and SLEDAI-2KG (glucocorticoid) indexes in patients with systemic lupus erythematosus (SLE)
  1. Selma Sari1,
  2. Bahar Artim Esen2,
  3. Ahmet Gül2,
  4. Lale Öcal2 and
  5. Murat İnanç2
  1. 1Dept. of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul
  2. 2Dept. of Internal Medicine, Division of Rheumatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey


Background Disease activity measurement in SLE can be performed with SLEDAI based on clinical and laboratory findings. The new SLEDAI-2K-glucocorticoid index (SLEDAI-2KG) developed from SLEDAI-2K calculates disease activity by taking into account the amount of glucocorticoids used. In this cross-sectional prospective study, two indexes were compared in consecutive SLE patients.

Methods Seventy-nine SLE patients were included into the study. Disease activity was evaluated using SLEDAI-2K and SLEDAI-2KG. Patients were grouped as SLEDAI = 0 (group 1), lupus low disease activity status (LLDAS) (group 2) and active disease (group 3). LLDAS was defined as:(SLEDAI)-2K ≤ 4, with no activity in major organ systems and no haemolytic anaemia or gastrointestinal activity; no new lupus disease activity; PGA (scale 0– 3) ≤1; a current prednisolone dose ≤7.5 mg daily; and stable maintenance doses of immunosuppressive drugs and approved biological agents.

Results Table 1 shows clinical features of SLE patients. Eighty-six percent of the patients were female. Median age 34 (range 18–74), median disease duration 36 (0–436) months. Thirty-five percent of the patients had renal activity, 7% had malar rash, 12% had alopecia, 2 (2.5%), 8% had thrombocytopenia, 8%had leucopenia, 3.8% had fever. Sixty-one percent of the patients had hypocomplementemia and 29% had anti-dsDNA positivity. Glucocorticoids were used by 63 patients and the median prednisone dose was 16 (0–75) mg. The median of SLEDAI-2K score of 79 patients was 4 (range 0–24) and the median of SLEDAI-2KG score was 7 (range 0–25). Significant positive correlation was found between SLEDAI-2K and SLEDAI-2KG scores(r=0,93, p<0,01). When SLEDAI-2K and SLEDAI-2KG were compared, the proportion of patients with disease activity 0 was 24% and 9%, LLDAS 20% and 27%, and active patients 56% and 64%, respectively.

Abstract P181 Table 1

Demographic and clinical characteristics of SLE patients

Conclusion Although there was a significant correlation between SLEDAI-2K and SLEDAI-2KG, more patients were defined as active with SLEDAI-2KG. Considering the importance of reducing glucocorticoid dose in clinical trials in the assessment of treatment response, SLEDAI-2KG may provide a more precise treatment response. Prospective studies are required to investigate the importance of SLEDAI-2KG in long-term prognosis of SLE patients.

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