RT Journal Article
SR Electronic
T1 BILAG-2004 index captures systemic lupus erythematosus disease activity better than SLEDAI-2000
JF Annals of the Rheumatic Diseases
JO Ann Rheum Dis
FD BMJ Publishing Group Ltd and European League Against Rheumatism
SP 873
OP 876
DO 10.1136/ard.2007.070847
VO 67
IS 6
A1 Yee, C-S
A1 Isenberg, D A
A1 Prabu, A
A1 Sokoll, K
A1 Teh, L-S
A1 Rahman, A
A1 Bruce, I N
A1 Griffiths, B
A1 Akil, M
A1 McHugh, N
A1 D’Cruz, D
A1 Khamashta, M A
A1 Maddison, P
A1 Zoma, A
A1 Gordon, C
YR 2008
UL http://ard.bmj.com/content/67/6/873.abstract
AB Objective: To assess the reliability of Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)-2000 index in routine practice and its ability to capture disease activity as compared with the British Isles Lupus Assessment Group (BILAG)-2004 index.Methods: Patients with systemic lupus erythematosus from 11 centres were assessed separately by two raters in routine practice. Disease activity was assessed using the BILAG-2004 and SLEDAI-2000 indices. The level of agreement for items was used to assess the reliability of SLEDAI-2000. The ability to detect disease activity was assessed by determining the number of patients with a high activity on BILAG-2004 (overall score A or B) but low SLEDAI-2000 score (<6) and number of patients with low activity on BILAG-2004 (overall score C, D or E) but high SLEDAI-2000 score (⩾6). Treatment of these patients was analysed, and the increase in treatment was used as the gold standard for active disease.Results: 93 patients (90.3% women, 69.9% Caucasian) were studied: mean age was 43.8 years, mean disease duration 10 years. There were 43 patients (46.2%) with a difference in SLEDAI-2000 score between the two raters and this difference was ⩾4 in 19 patients (20.4%). Agreement for each of the items in SLEDAI-2000 was between 81.7 and 100%. 35 patients (37.6%) had high activity on BILAG-2004 but a low SLEDAI-2000 score, of which 48.6% had treatment increased. There were only five patients (5.4%) with low activity on BILAG-2004 but a high SLEDAI-2000 score.Conclusions: SLEDAI-2000 is a reliable index to assess systemic lupus erythematosus disease activity but it is less able than the BILAG-2004 index to detect active disease requiring increased treatment.