• Systemic Lupus Erythematosus
• Outcomes research
• Disease Activity

We read with interest the article by Wilhelm et al, reporting the frequency, durability and predictors of four definitions of remission, agreed upon by an international groups of experts (Definition of Remission in Systemic Lupus Erythematosus (SLE); DORIS, in the Baltimore lupus cohort.1

As the premise of defining remission is to provide a therapeutic target to guide the management of SLE, we question the value of having four definitions. We further argue that the complete absence of clinical disease activity off of all treatment may simply identify a small group of patients who inherently have a less severe disease …