The effect of systemic lupus erythematosus (SLE) Disease Activity Score and SLE Disease Activity Index 2000‐based remission states in patients with SLE on damage accrual

Abstract

AbstractBackground/ObjectiveThis study aimed to compare the effect of the Systemic Lupus Erythematosus Disease Activity Score (SLE‐DAS) with the SLE Disease Activity Index 2000 (SLEDAI‐2K) remission state on damage accrual.MethodsThis study classified SLE patients from the Lupus Clinic of the Royal Thai Army (LUCRA) cohort based on the SLE‐DAS index, or Boolean‐based, and SLEDAI‐2K (Doria) remission state. Regression analysis models were constructed to identify predictors of the Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI) during follow‐up.ResultsThere were 197 patients identified; 97 patients met at least one definition of remission state, and 100 patients were in the non‐remission group at enrollment. Of 97 patients, 97 achieved the SLE‐DAS index‐based definition, 74 achieved the SLE‐DAS Boolean‐based definition, and 55 achieved the Doria definition. The mean ± SD of follow‐up was 4.77 ± 0.6 years. The changes in SDI over time were non‐significantly lower in patients who met any definition of remission compared with those who did not. Multivariate analysis revealed that predictive factors for increased SDI were age and baseline SDI ≥ 1. SLE‐DAS index, Boolean, and Doria‐based definitions of remission at enrollment had no significant risk reduction on SDI compared with the non‐remission group (HR 0.7, 95% CI 0.37–1.32, p = .27; HR 0.73, 95% CI 0.37–1.44, p = .37; HR 0.8, 95% CI 0.39–1.65, p = .55, respectively).ConclusionsPatients with SLE who achieved remission status according to the SLE‐DAS index or SLEDAI‐2K definitions did not show any significant difference in damage accrual compared to those who were not in remission.