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.
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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