Table 4

Impact of LDA on damage

Authors	Patients	Follow-up years	LDA								Impact
Authors	Patients	Follow-up years	Disease activity index	Exclusion of New activity	Major Organ Exclusion	PGA	PDN daily dose	IS use	AM use	Minimal duration	Impact
Polachek et al7	620	4	SLEDAI<=2	No	No	NR	Not allowed	Not allowed	Allowed	1 year	Remission+LDA vs active: 0.15 vs 0.52, p<0.001 (year 2); 0.25 vs 0.88, p<0.001 (year 4)
Ugarte-Gil et al14*	1350	2.4	SLEDAI<=4	No	No	NR	<=7.5	Allowed	Allowed	At least once	Excluding remission new damage (reference active) HR 0.66, p=0.0158
Ugarte-Gil et al14*	1350	2.4	SLEDAI<=4	No	No	NR	<=7.5	Allowed	Allowed	At least once	Excluding remission new severe damage (reference active) HR 0.54, p=0.0614
Ugarte-Gil et al14*	1350	2.4	SLEDAI<=4	No	No	NR	<=7.5	Allowed	Allowed	At least once	Excluding remission new severe damage (reference active) HR 0.54, p=0.0614
Ugarte-Gil et al14*	1350	2.4	SLEDAI<=4	No	No	NR	<=7.5	Allowed	Allowed	At least once	Excluding remission new damage non-GC (reference active) HR 0.62, p=0.0067
Ugarte-Gil et al14*	1350	2.4	SLEDAI<=4	No	No	NR	<=7.5	Allowed	Allowed	At least once	Excluding remission new severe damage non-GC (reference active) HR 0.35, p=0.0206
Ugarte-Gil et al14*	1350	2.4	SLEDAI<=4	No	No	NR	<=7.5	Allowed	Allowed	at least once	Excluding remission new damage GC (reference active) HR 1.34, p=0.3333
Tsang-A-Sjoe et al15	183	5	SLEDAI<=4	No	Yes	<=2/10	<=7.5	Allowed	Allowed		>50% on LLDAS: OR=0.52, p=0.046
Tani et al11*	115	At least 5	SLEDAI<=4	No	Yes	<=1	<=7.5	Allowed	Allowed	100% of the follow-up	∆SDI: 0.11 vs 0.63; p<0.001
Tani et al11*	115	at least 5	SLEDAI<=4	No	Yes	<=1	<=7.5	Allowed	Allowed	50%	∆SDI: 0.25 vs 0.78; p=0.004
Zen et al17*	293	7	SLEDAI<=4	Yes	Yes	<=1	<=7.5	Allowed	Allowed	1 year	1 year (reference <1 year) OR 0.899, p=0.877
Zen et al1717*	293	7	SLEDAI<=4	Yes	Yes	<=1	<=7.5	Allowed	Allowed	2 years	2 years (reference <1 year) OR 0.279, p=0.036
Zen et al17*	293	7	SLEDAI<=4	Yes	Yes	<=1	<=7.5	Allowed	Allowed	3 years	3 years (reference <1 year) OR 0.252, p=0.025
Zen et al17*	293	7	SLEDAI<=4	Yes	Yes	<=1	<=7.5	Allowed	Allowed	4 years	4 years (reference <1 year) OR 0.122, p=0.001
Zen et al1717*	293	7	SLEDAI<=4	Yes	Yes	<=1	<=7.5	Allowed	Allowed	5 years	≥5 years (reference <1 year) OR 0.071, p<0.001
Petri et al18	1356	NR	SLEDAI<=4	Yes	Yes	<=1	<=7.5	Allowed	Allowed	NR	Less than 25% RR 0.80, p=0.12, 25%–50% on remission RR 0.63, p=0.0012, 50%–75% RR 0.47, p<0.0001, >=75%, RR 0.39, p<0.0001 (reference not LLDAS)
Alarcon et al20	558	NR	SLAM<=3	No	No	NR	<=7.5	Not allowed	Allowed	NR	Duration on LDAS RR: 0.1773, p<0.0001 LDAS prevented from GC-related and non-GC-related damage
Golder et al38*	1707	2.2	SLEDAI<=4	Yes	Yes	<=1	<=7.5	Allowed	Allowed	NR	HR 0.54, p<0.0001
Golder et al38*	1707	2.2	SLEDAI<=4	Yes	Yes	<=1	<=7.5	Allowed	Allowed	NR	HR 0.59, p<0.0001
Golder et al38*	1707	2.2	SLEDAI<=4	Yes	Yes	<=1	<=7.5	Allowed	Allowed	NR	RR 0.14 p<0.0001
Sharma et al40*	206	10	SLEDAI<=4	Yes	Yes	NR	<=7.5	Allowed	Allowed	50%	HR 0.37, p<0.01 (SDI>=3)
Sharma et al40*	206	10	SLEDAI<=4	Yes	Yes	NR	<=7.5	Allowed	Allowed	30%	HR 0.57, p=0.08 (SDI>=3)
Sharma et al40*	206	10	SLEDAI<=4	Yes	Yes	NR	<=7.5	Allowed	Allowed	70%	HR 0.38, p<0.01 (SDI>=3)
Floris et al34	116	1.5	SLEDAI<=4	Yes	Yes	<=1	<=7.5	Allowed	Allowed	NR	LLDAS (not in remission) OR 0.25, p=0.049
Kang et al43*	299	4	C-SLEDAI<=1	NR	NR	NR	5	Allowed	Allowed	NR	B=−0.033, p=0.368
Kang et al43*	299	4	C-SLEDAI<=2	NR	NR	NR	0	Not allowed	allowed	NR	B=−0.093, p=0.390
Kang et al43*	299	4	SLEDAI<=4	Yes	Yes	<=1	<=7.5	Allowed	Allowed	NR	B=−0.064, p=0.050

*If an article included more than one definition, a row per definition is included.
AM, antimalarials; C-SLEDAI, Clinical Systemic Lupus Erythematosus Disease Activity Index ; IS, immunosuppressive drug; LDA, low disease activity; LDAS, low disease activity status; LLDAS, lupus low disease activity state; ;NR, not reported; PDN, prednisone; PGA, Physician Global Assessment; SLAM, Systemic Lupus Activity Measure.