Statements, generated as the result of substantial reviews of the literature and data from individual registries and clinical trial data sets, and supported by the DORIS Task Force
| Vote in favour | LoE | GoR | Agreement | |
| 1. Inclusion of serology (anti-DNA, complement) in the DORIS definition of remission on-treatment does not meaningfully alter the construct validity and therefore it is not recommended to include it. | 90% | 2a | B | 8.38 |
| 2. While the goal of treatment is sustained remission, a definition of remission should be able to be met at any point in time; therefore, duration should not be included in the definition. | 100% | 5 | C | 9.02 |
| 3. To date, the SLEDAI-based definitions of remission have formally been investigated more extensively than BILAG-based or ECLAM-based definitions. The SLEDAI-based definitions can therefore more confidently be recommended. | 91% | 2a | B | 9.25 |
| 4. Remission off-treatment, while the ultimate goal for many patients and care providers, is achieved very rarely. In clinical research and as an outcome in clinical trials, the definition for remission on-treatment is recommended. | 92% | 2a | B | 9.52 |
| 5. In clinical trials, the LLDAS definition for low disease activity and the DORIS definition of remission are both recommended as outcomes. | 100% | 5 | C | 9.25 |
| Final recommendation: The task force supports the 2021 DORIS definition of remission in SLE: cSLEDAI=0 and PhGA <0.5, irrespective of serology; the patient may be on antimalarials, low-dose glucocorticoids (prednisolone <5 mg/day), and/or stable immunosuppressives including biologics. | 97% | 9.07 |
Agreement=the average of individual task force members’ agreements with the statement on a scale of 1–10.
Note that GoRs were not easily applied to recommendations 2 and 5; we considered these consensus statements to be ‘extrapolations from level 2 or 3 studies’, yielding a GoR of C.
BILAG, British isles lupus assessment group; cSLEDAI, clinical SLEDAI; DORIS, Definitions Of Remission In SLE; ECLAM, European consensus lupus activity measure; GoR, grade of recommendation; LLDAS, lupus low disease activity state; LoE, level of evidence; PhGA, Physician Global Assessment; SLEDAI, systemic lupus erythematosus disease activitiy index.