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Title: | A framework for remission in SLE: consensus findings from a large international task force on definitions of remission in SLE (DORIS) |
Authors: | VOLLENHOVEN, Ronald van; VOSKUYL, Alexandre; BERTSIAS, George; ARANOW, Cynthia; ARINGER, Martin; ARNAUD, Laurent; ASKANASE, Anca; BALAZOVA, Petra; BONFA, Eloisa; BOOTSMA, Hendrika; BOUMPAS, Dimitrios; BRUCE, Ian; CERVERA, Ricard; CLARKE, Ann; CONEY, Cindy; COSTEDOAT-CHALUMEAU, Nathalie; CZIRJAK, Laszlo; DERKSEN, Ronald; DORIA, Andrea; DOERNER, Thomas; FISCHER-BETZ, Rebecca; FRITSCH-STORK, Ruth; GORDON, Caroline; GRANINGER, Winfried; GYORI, Noemi; HOUSSIAU, Frederic; ISENBERG, David; JACOBSEN, Soren; JAYNE, David; KUHN, Annegret; GUERN, Veronique Le; LERSTROM, Kirsten; LEVY, Roger; MACHADO-RIBEIRO, Francinne; MARIETTE, Xavier; MISSAYKEH, Jamil; MORAND, Eric; MOSCA, Marta; INANC, Murat; NAVARRA, Sandra; NEUMANN, Irmgard; OLESINSKA, Marzena; PETRI, Michelle; RAHMAN, Anisur; REKVIG, Ole Petter; ROVENSKY, Jozef; SHOENFELD, Yehuda; SMOLEN, Josef; TINCANI, Angela; UROWITZ, Murray; LEEUW, Bernadette van; VASCONCELOS, Carlos; VOSS, Anne; WERTH, Victoria P.; ZAKHAROVA, Helena; ZOMA, Asad; SCHNEIDER, Matthias; WARD, Michael |
Citation: | ANNALS OF THE RHEUMATIC DISEASES, v.76, n.3, p.554-561, 2017 |
Abstract: | Objectives Treat-to-target recommendations have identified `remission' as a target in systemic lupus erythematosus (SLE), but recognise that there is no universally accepted definition for this. Therefore, we initiated a process to achieve consensus on potential definitions for remission in SLE. Methods An international task force of 60 specialists and patient representatives participated in preparatory exercises, a face-to-face meeting and follow-up electronic voting. The level for agreement was set at 90%. Results The task force agreed on eight key statements regarding remission in SLE and three principles to guide the further development of remission definitions: 1. Definitions of remission will be worded as follows: remission in SLE is a durable state characterised by ... (reference to symptoms, signs, routine labs). 2. For defining remission, a validated index must be used, for example, clinical systemic lupus erythematosus disease activity index (SLEDAI)=0, British Isles lupus assessment group (BILAG) 2004 D/E only, clinical European consensus lupus outcome measure (ECLAM)=0; with routine laboratory assessments included, and supplemented with physician's global assessment. 3. Distinction is made between remission off and on therapy: remission off therapy requires the patient to be on no other treatment for SLE than maintenance antimalarials; and remission on therapy allows patients to be on stable maintenance antimalarials, low-dose corticosteroids (prednisone <= 5 mg/day), maintenance immunosuppressives and/or maintenance biologics. The task force also agreed that the most appropriate outcomes (dependent variables) for testing the prognostic value (construct validity) of potential remission definitions are: death, damage, flares and measures of health-related quality of life. Conclusions The work of this international task force provides a framework for testing different definitions of remission against long-term outcomes. |
Appears in Collections: | Artigos e Materiais de Revistas Científicas - FM/MCM Artigos e Materiais de Revistas Científicas - LIM/17 Artigos e Materiais de Revistas Científicas - ODS/03 |
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