Novel Disease Activity Tool Validated to Detect Changes in SLE

SLE of in the hand
Researchers validated the SLE Disease Activity Score with improved sensitivity to change compared with SLE Disease Activity Index.

The novel systemic lupus erythematosus (SLE) disease activity assessment tool, SLE Disease Activity Score (SLE-DAS), has been validated to detect more clinically relevant differences in SLE disease activity compared with previous tools, according to results from a study published in the Annals of the Rheumatic Diseases.  

Researchers conducted a prospective cohort study of 520 patients with SLE from 2 different treatment centers. Participants were recruited for up to 5 years, and 2 separate cohorts were used to validate the tool. Multivariate regression techniques were applied to data from patients within the SLE-DAS cohort to create the instrument. During follow-up, clinicians measured disease activity using the SLE Disease Activity Index 2000 (SLEDAI-2K) and Physician Global Assessment (PGA) tools, which are currently used in clinical trials.   

After analysis, the researchers were able to construct and validate the SLE-DAS instrument successfully. The SLE-DAS provides a continuous score derived from 17 distinct parameters to measure global disease activity. Furthermore, the authors reported greater sensitivity with the SLE-DAS tool than with the SLEDAI-2K to identify clinically significant improvement (89.5% vs 47.4%; P =.008) or decline (95.5% vs 59.1%; P =.008) in SLE activity over time. However, both tools showed comparable sensitivity.

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“Limitations of our study include the use given to PGA, given its subjective nature,” the researchers wrote.

“SLE-DAS has a good construct validity and has better performance than SLEDAI-2K in identifying clinically significant changes in disease activity and in predicting damage accrual,” they concluded.

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Jesus D, Matos A, Henriques C, et al. Derivation and validation of the SLE Disease Activity Score (SLE-DAS): a new SLE continuous measure with high sensitivity for changes in disease activity [published online January 9, 2019]. Ann Rheum Dis. doi:10.1136/annrheumdis-2018-214502