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Derivation and validation of the SLE Disease Activity Score (SLE-DAS): a new SLE continuous measure with high sensitivity for changes in disease activity

2019-01Journal article Open access
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dc.contributor.authorJesus, Diogo
dc.contributor.authorCristina Bico Rodrigues de Matos, Ana
dc.contributor.authorHenriques, C.
dc.contributor.authorZen, Margherita
dc.contributor.authorLarosa, Maddalena
dc.contributor.authorIaccarino, Luca
dc.contributor.authorDa Silva, José António Pereira
dc.contributor.authorDoria, Andrea
dc.contributor.authorInês, Luís Sousa
dc.date.accessioned2019-06-18T10:39:44Z
dc.date.available2019-06-18T10:39:44Z
dc.date.issued2019-01
dc.description.abstractObjectives To derive and validate a new disease activity measure for systemic lupus erythematosus (SLE), the SLE Disease Activity Score (SLE-DAS), with improved sensitivity to change as compared with SLE Disease Activity Index (SLEDAI), while maintaining high specificity and easiness of use. Methods We studied 520 patients with SLE from two tertiary care centres (derivation and validation cohorts). At each visit, disease activity was scored using the Physician Global Assessment (PGA) and SLEDAI 2000 (SLEDAI-2K). To construct the SLE-DAS, we applied multivariate linear regression analysis in the derivation cohort, with PGA as dependent variable. The formula was validated in a different cohort through the study of: (1) correlations between SLE-DAS, PGA and SLEDAI-2K; (2) performance of SLEDAI-2K and SLE-DAS in identifying a clinically meaningful change in disease activity (ΔPGA≥0.3); and (3) accuracy of SLEDAI-2K and SLE-DAS time-adjusted means in predicting damage accrual. Results The final SLE-DAS instrument included 17 items. SLE-DAS was highly correlated with PGA (r=0.875, p<0.0005) and SLEDAI-2K (r=0.943, p<0.0005) in the validation cohort. The optimal discriminative ΔSLE-DAS cut-off to detect a clinically meaningful change was 1.72. In the validation cohort, SLE-DAS showed a higher sensitivity than SLEDAI-2K (change ≥4) to detect a clinically meaningful improvement (89.5% vs 47.4%, p=0.008) or worsening (95.5% vs 59.1%, p=0.008), while maintaining similar specificities. SLE-DAS performed better in predicting damage accrual than SLEDAI-2K. Conclusion SLE-DAS has a good construct validity and has better performance than SLEDAI-2K in identifying clinically significant changes in disease activity and in predicting damage accrual.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationJesus, D., Matos, A., Henriques, C., Zen, M., Larosa, M., Iaccarino, L., … Inês, L. S. (2019). Derivation and validation of the SLE Disease Activity Score (SLE-DAS): a new SLE continuous measure with high sensitivity for changes in disease activity. Annals of the Rheumatic Diseases, 78(3), 365–371. https://doi.org/10.1136/annrheumdis-2018-214502pt_PT
dc.identifier.doi10.1136/annrheumdis-2018-214502pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.19/5557
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherEULAR textbookspt_PT
dc.relation.publisherversionhttps://ard.bmj.com/content/78/3/365pt_PT
dc.titleDerivation and validation of the SLE Disease Activity Score (SLE-DAS): a new SLE continuous measure with high sensitivity for changes in disease activitypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage371pt_PT
oaire.citation.issue3pt_PT
oaire.citation.startPage365pt_PT
oaire.citation.volume78pt_PT
person.familyNameMatos
person.familyNameHenriques
person.givenNameAna
person.givenNameCarla
person.identifier.ciencia-id961C-1FBD-5555
person.identifier.ciencia-idF91C-B000-9ED8
person.identifier.orcid0000-0001-6408-5857
person.identifier.orcid0000-0002-2142-2849
person.identifier.scopus-author-id8506082100
person.identifier.scopus-author-id8955187400
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication69997266-781a-4811-ab7b-5282d69b00e6
relation.isAuthorOfPublication9138da60-0a34-4302-b547-864d612c30b8
relation.isAuthorOfPublication.latestForDiscovery69997266-781a-4811-ab7b-5282d69b00e6

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