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PO.7.156 Does expert opinion match the definitions of low disease activity state? Prospective analysis of 500 patients from a spanish multicenter cohort
  1. I Altabás González1,
  2. Í Rúa-Figueroa2,
  3. F Rubiño2,
  4. C Mouriño1,
  5. R Menor Almagro3,
  6. E Uriarte Isacelaya4,
  7. E Tomer Muriel5,
  8. TC Salman-Monte6,
  9. I Carrión-Barberà6,
  10. M Galindo7,
  11. E Rodríguez-Almaraz7,
  12. N Jiménez8 and
  13. JM Pego-Reigosa1
  1. 1Complejo Hospitalario Universitario de Vigo ~ Vigo ~ Spain
  2. 2Hospital Universitario de Gran Canaria Doctor Negrín ~ Las palmas de Gran Canaria ~ Spain
  3. 3Hospital Universitario de Jerez de la Frontera ~ Cadiz ~ Spain
  4. 4Hospital Universitario de Donostia ~ San Sebastián ~ Spain
  5. 5Hospital Universitario de la Princesa ~ Madrid ~ Spain
  6. 6Hospital del Mar ~ Barcelona ~ Spain
  7. 7Hospital Universitario 12 de Octubre ~ Madrid ~ Spain
  8. 8Grupo IRIDIS ~ Vigo ~ Spain


OBJECTIVES To apply current definitions of Lupus Low Disease Activity State (LLDAS) to a large cohort and evaluate the concordance between LLDAS and the clinical status according to the expert opinion.

Methods A cross-sectional analysis of a prospective multicenter study of SLE patients from seven Spanish Rheumatology Departments with high level of expertise in SLE. We applied the LLDAS definition and evaluated the agreement between the LLDAS and the clinical status according to the expert opinion. Modifications in LLDAS definition were also explored.

Results 508 patients were included (92% women; mean age (±SD): 50.4 years (± 13.7). A total of 267 (54.4%) patients were in DORIS remission and 304 (62.7%) in LLDAS. Remission was the most frequent state considered by the rheumatologist (n=206, 41.6%). Agreement between expert opinion and LLDAS was 71.4%. Most cases (96.1%) in LLDAS, were classified as remission or low activity by the expert. Of the patients that did not fulfill LLDAS, 126 (70.4%) patients were classified as remission/low disease activity (Figure 1). The main reasons for discordance were the presence of new manifestations compared to previous visit and a SLEDAI 2-K >4 (Table 1). The modification of the LLDAS definition excluding the comparison with previous assessment increases the agreement to 82.6% (95% CI: 81.61–83.96%). Decreasing the cutoff point of prednisone dose to 5mg/daily did not change the agreement (Table 2).

Abstract PO.7.156 Table 1

Reason of disagreement between patients that did not fulfill LLDAS definition and expert assessment as remission or low disease activity

Abstract PO.7.156 Figure 1

Comparison of LLDAS and expert opinion

Abstract PO.7.156 Table 2

Agreement between expert opinion and definition of LLDAS or modified LLDAS definition

Conclusion Almost two thirds of SLE patients were in DORIS remission or in LLDAS. There is a good correlation between LLDAS and the physician’s opinion, particularly for those patients who fulfill LLDAS definition. A modification in LLDAS definition excluding the comparison with previous assessment have an increase in the agreement with the expert opinion.

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