Background There are valid tools to measure disease activity and damage in JSLE, but to date there is no gold standard.
Objectives To test the correlation between two activity indices, the M-SLEDAI-2K and ECLAM, and their respective correlation to the Pediatric SLICC/ACR Damage Index (Ped-SDI) during standard care of JSLE patients.
Methods M-SLEDAI-2K is a variant of the original SLEDAI-2K where a-DNA and complement testing is suppressed for feasibility of standard approach (Uribe et al., 2004). It has not been previously tested in JSLE. The tools were retrospectively scored during follow up and summarized by adjusted means and area under the curve (AUC). The Pediatric SLICC/ACR Damage Index (Ped-SDI) was scored during the last visit and only after the first year of follow up. Pearson correlation between the M-SLEDAI-2K and ECLAM and Spearman correlation between the M-SLEDAI-2K and ECLAM, respectively to Ped-SDI were calculated. ROC analysis tested discriminating properties of both activity indices in relation to Ped-SDI damage scores.
Results Thirty seven patients with 11.2 years median age at diagnosis and 2.7 years median follow up were scored during 781 visits. The M-SLEDAI-2K and ECLAM adjusted means were highly correlated (r Pearson =0.78 and p<0.0001; Figure 1). Similarly, a strong correlation was found for both at disease presentation and throughout disease course (r Spearman >0.7 and p<0.001). Correlation between the M-SLEDAI-2K and ECLAM respectively to Ped-SDI was moderate. Their respective ROC AUC were 0.74 and 0.73, and cutoff points of 3.62 and 1.28, discriminating Ped-SDI.
Conclusions The strong correlation between the M-SLEDAI-2K and ECLAM on retrospective approach indicated that both tools may be equally useful for JSLE activity measure in clinical practice.
Uribe AG, Vilá LM, McGwin G Jr, Sanchez ML, Reveille JD, Alarcόn GS. The Systemic Lupus Activity Measure-revised, the Mexican Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), and a modified SLEDAI-2K are adequate instruments to measure disease activity in systemic lupus erythematosus. J Rheumatol 2004; 31: 1934-40.
Disclosure of Interest None declared
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