RT Journal Article
SR Electronic
T1 A framework for remission in SLE: consensus findings from a large international task force on definitions of remission in SLE (DORIS)
JF Annals of the Rheumatic Diseases
JO Ann Rheum Dis
FD BMJ Publishing Group Ltd and European League Against Rheumatism
SP 554
OP 561
DO 10.1136/annrheumdis-2016-209519
VO 76
IS 3
A1 Ronald van Vollenhoven
A1 Alexandre Voskuyl
A1 George Bertsias
A1 Cynthia Aranow
A1 Martin Aringer
A1 Laurent Arnaud
A1 Anca Askanase
A1 Petra Balážová
A1 Eloisa Bonfa
A1 Hendrika Bootsma
A1 Dimitrios Boumpas
A1 Ian Bruce
A1 Ricard Cervera
A1 Ann Clarke
A1 Cindy Coney
A1 Nathalie Costedoat-Chalumeau
A1 László Czirják
A1 Ronald Derksen
A1 Andrea Doria
A1 Thomas Dörner
A1 Rebecca Fischer-Betz
A1 Ruth Fritsch-Stork
A1 Caroline Gordon
A1 Winfried Graninger
A1 Noémi Györi
A1 Frédéric Houssiau
A1 David Isenberg
A1 Soren Jacobsen
A1 David Jayne
A1 Annegret Kuhn
A1 Veronique Le Guern
A1 Kirsten Lerstrøm
A1 Roger Levy
A1 Francinne Machado-Ribeiro
A1 Xavier Mariette
A1 Jamil Missaykeh
A1 Eric Morand
A1 Marta Mosca
A1 Murat Inanc
A1 Sandra Navarra
A1 Irmgard Neumann
A1 Marzena Olesinska
A1 Michelle Petri
A1 Anisur Rahman
A1 Ole Petter Rekvig
A1 Jozef Rovensky
A1 Yehuda Shoenfeld
A1 Josef Smolen
A1 Angela Tincani
A1 Murray Urowitz
A1 Bernadette van Leeuw
A1 Carlos Vasconcelos
A1 Anne Voss
A1 Victoria P Werth
A1 Helena Zakharova
A1 Asad Zoma
A1 Matthias Schneider
A1 Michael Ward
YR 2017
UL http://ard.bmj.com/content/76/3/554.abstract
AB 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.