A framework for remission in SLE: consensus findings from a large international task force on definitions of remission in SLE (DORIS)

被引：299

作者：

van Vollenhoven, Ronald ^{[1
]}

Voskuyl, Alexandre ^{[1
]}

Bertsias, George ^{[2
]}

Aranow, Cynthia ^{[3
]}

Aringer, Martin ^{[4
]}

Arnaud, Laurent

Askanase, Anca ^{[5
]}

Balazova, Petra ^{[6
]}

Bonfa, Eloisa ^{[7
]}

Bootsma, Hendrika ^{[8
]}

Boumpas, Dimitrios ^{[9
,10
]}

Bruce, Ian ^{[11
]}

Cervera, Ricard ^{[12
]}

Clarke, Ann ^{[13
]}

Coney, Cindy ^{[14
]}

Costedoat-Chalumeau, Nathalie ^{[15
,16
]}

Czirjak, Laszlo ^{[17
,18
]}

Derksen, Ronald

Doria, Andrea ^{[20
]}

Doerner, Thomas ^{[21
]}

Fischer-Betz, Rebecca ^{[22
]}

Fritsch-Stork, Ruth ^{[19
]}

Gordon, Caroline ^{[23
]}

Graninger, Winfried ^{[24
]}

Gyori, Noemi

Houssiau, Frederic ^{[25
]}

Isenberg, David ^{[26
]}

Jacobsen, Soren ^{[27
]}

Jayne, David ^{[28
]}

Kuhn, Annegret ^{[29
]}

Le Guern, Veronique ^{[15
,16
]}

Lerstrom, Kirsten ^{[30
]}

Levy, Roger ^{[31
]}

Machado-Ribeiro, Francinne ^{[31
]}

Mariette, Xavier ^{[32
]}

Missaykeh, Jamil ^{[33
]}

Morand, Eric ^{[34
]}

Mosca, Marta

Inanc, Murat ^{[35
]}

Navarra, Sandra ^{[36
]}

Neumann, Irmgard ^{[37
]}

Olesinska, Marzena ^{[38
]}

Petri, Michelle ^{[39
,40
]}

Rahman, Anisur ^{[26
]}

Rekvig, Ole Petter ^{[41
]}

Rovensky, Jozef ^{[42
]}

Shoenfeld, Yehuda ^{[43
]}

Smolen, Josef ^{[44
,45
]}

Tincani, Angela ^{[46
]}

Urowitz, Murray ^{[47
]}

机构：

[1] D100 Karolinska Univ Hosp, Karolinska Inst, Inflammatory Dis ClinTRID, Unit Clin Therapy Res,Dept Med, Stockholm, Sweden

[2] Vrije Univ Amsterdam Med Ctr, Amsterdam Rheumatol & Immunol Ctr, Amsterdam, Netherlands

[3] Univ Crete, Sch Med, Dept Rheumatol Clin Immunol & Allergy, Iraklion, Greece

[4] Feinstein Inst Med Res, Manhasset, NY USA

[5] Tech Univ Dresden, Univ Med Ctr, Dept Med 3, Dresden, Germany

[6] NYU, New York, NY USA

[7] LPRe SR Klub Motylik, Bratislava, Slovakia

[8] Univ Sao Paulo, Fac Med, Div Rheumatol, Sao Paulo, Brazil

[9] Univ Groningen, Univ Med Ctr Groningen, Dept Rheumatol & Clin Immunol, Groningen, Netherlands

[10] Univ Athens, Dept Med, Athens, Greece

[11] Univ Athens, Joint Acad Rheumatol Program, Sch Med, Athens, Greece

[12] Univ Manchester & Cent Manchester Fdn Trust, NIHR Manchester Biomed Res Unit, Manchester, Lancs, England

[13] Hosp Clin Barcelona, Dept Autoimmune Dis, Barcelona, Catalonia, Spain

[14] Univ Calgary, Cumming Sch Med, Arthrit Soc Chair Rheumat Dis, Div Rheumatol, Calgary, AB, Canada

[15] Lupus Fdn Amer, Washington, DC USA

[16] Univ Paris Decartes, Paris, France

[17] Hop Cochin, AP HP, Serv Med Interne, Ctr Reference Malad Auto Immunes & Syst Rares, Paris, France

[18] Univ Pecs, Inst Family Med, Inst Bioanal, Dept Rheumatol & Immunol, Pecs, Hungary

[19] Semmelweis Univ, Dept Internal Med 3, Budapest, Hungary

[20] Univ Med Ctr, Dept Rheumatol & Clin Immunol, Utrecht, Netherlands

[21] Univ Padua, Dept Med, Rheumatol Unit, Padua, Italy

[22] Charite, Dept Med Rheumatol & Clin Immunol, Berlin, Germany

[23] Univ Dusseldorf, Univ Clin Duesseldorf, Hiller Res Unit, Polyclin Rheumatol, Dusseldorf, Germany

[24] Univ Birmingham, Coll Med & Dent Sci, Inst Inflammat & Ageing, Rheumatol Res Grp, Birmingham, W Midlands, England

[25] Med Univ Graz, Div Rheumatol, Graz, Austria

[26] Catholic Univ Louvain, Inst Rech Expt & Clin, Pole Pathol Rhumatism Inflammatoires & Syst, Serv Rhumatol,Clin Univ St Luc, Brussels, Belgium

[27] UCL, Ctr Rheumatol, Dept Med, London, England

[28] Ctr Rheumatol & Spine Dis, Copenhagen Lupus & Vasculitis Clin, Copenhagen, Denmark

[29] Univ Cambridge, Dept Med, Cambridge, England

[30] Univ Med Ctr Mainz, Interdisciplinary Ctr Clin Trials IZKS, Mainz, Germany

[31] LUPUS EUROPE, Romford, Essex, England

[32] Univ Estado Rio de Janeiro, Dept Rheumatol, Rio De Janeiro, Brazil

[33] Univ Paris 11, Hop Univ Paris Sud, AP HP, INSERM,U1184, Le Kremlin Bicetre, France

[34] Monla Hosp, Bone Densitometry Unit, Tripoli, Libya

[35] Monash Univ, Monash Med Ctr, Fac Med Nursing & Hlth Sci, Clayton, Vic, Australia

[36] Univ Pisa, Dept Clin & Expt Med, Rheumatol Unit, Pisa, Italy

[37] Istanbul Univ, Istanbul Fac Med, Div Rheumatol, Dept Internal Med, Istanbul, Turkey

[38] Univ Santo Tomas, Manila, Philippines

[39] Vasculitis At, Vienna, Austria

[40] Natl Inst Geriatr Rheumatol & Rehabil, Dept Connect Tissues Dis, Warsaw, Poland

[41] Johns Hopkins Univ, Sch Med, Baltimore, MD USA

[42] Univ Tromso, Fac Hlth Sci, Inst Med Biol, RNA & Mol Pathol Res Grp, Tromso, Norway

[43] Natl Inst Rheumat Dis, Piestany, Slovakia

[44] Tel Aviv Univ, Sheba Med Ctr, Zabludowicz Ctr Autoimmune Dis, Tel Aviv, Israel

[45] Med Univ Vienna, Dept Med 3, Div Rheumatol, Vienna, Austria

[46] Hietzing Hosp, Dept Med 2, Vienna, Austria

[47] Univ Brescia, Dipartimento Sci Clin & Sperimentali, Spedali Civ Brescia, UO Reumatol Immunol Clin, Brescia, Italy

[48] Univ Toronto, Toronto Western Hosp, Ctr Prognosis Studies Rheumat Dis, Senior Scientist Krembil Res Inst,Med, Toronto, ON, Canada

[49] Univ Porto, UMIB, Inst Ciencias Biomed Abel Salazar, Hosp Santo Antonio,Ctr Hosp Porto,Unidade Imunol, Porto, Portugal

[50] Univ Southern Denmark, Odense Univ Hosp, Dept Rheumatol, Odense, Denmark

来源：

ANNALS OF THE RHEUMATIC DISEASES | 2017年 / 76卷 / 03期

关键词：

SYSTEMIC-LUPUS-ERYTHEMATOSUS; DISEASE-ACTIVITY; RETROSPECTIVE ANALYSIS; INITIAL VALIDATION; NEPHRITIS PATIENTS; AMERICAN-COLLEGE; CHINESE PATIENTS; RENAL FLARES; PREDICTORS; DAMAGE;

D O I：

10.1136/annrheumdis-2016-209519

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页码：554 / 561

页数：8

共 43 条

[1] Strategy for second kidney biopsy in patients with lupus nephritis [J].

Alsuwaida, Abdulkareem ;

Husain, Sufia ;

Alghonaim, Mohammed ;

AlOudah, Noura ;

Alwakeel, Jamal ;

Ullah, Anhar ;

Kfoury, Hala .

NEPHROLOGY DIALYSIS TRANSPLANTATION, 2012, 27 (04) :1472-1478

[2] Predictors of poor renal outcome in patients with biopsy-proven lupus nephritis [J].

Ayodele, Olugbenga Edward ;

Okpechi, Ikechi G. ;

Swanepoel, Charles R. .

NEPHROLOGY, 2010, 15 (04) :482-490

[3]

Barr SG, 1999, ARTHRITIS RHEUM, V42, P2682, DOI 10.1002/1529-0131(199912)42:12<2682::AID-ANR26>3.0.CO

[4]

2-6

[5]

BEST WR, 1976, GASTROENTEROLOGY, V70, P439

[6] Drivers of cost and health-related quality of life in patients with systemic lupus erythematosus (SLE): a Swedish nationwide study based on patient reports [J].

Bexelius, C. ;

Wachtmeister, K. ;

Skare, P. ;

Jonsson, L. ;

van Vollenhoven, R. .

LUPUS, 2013, 22 (08) :793-801

[7] Value of a complete or partial remission in severe lupus nephritis [J].

Chen, Yiann E. ;

Korbet, Stephen M. ;

Katz, Robert S. ;

Schwartz, Melvin M. ;

Lewis, Edmund J. .

CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2008, 3 (01) :46-53

[8] Predictors of Long-Term Renal Outcome in Lupus Nephritis Trials Lessons Learned from the Euro-Lupus Nephritis Cohort [J].

Dall'Era, Maria ;

Cisternas, Miriam G. ;

Smilek, Dawn E. ;

Straub, Laura ;

Houssiau, Frederic A. ;

Cervera, Ricard ;

Rovin, Brad H. ;

Mackay, Meggan .

ARTHRITIS & RHEUMATOLOGY, 2015, 67 (05) :1305-1313

[9] Assessment of long-term remission in lupus nephritis patients: a retrospective analysis over 30 years [J].

das Neves, Marisa Fernandes ;

Irlapati, Rajendra Vara Prasad ;

Isenberg, David .

RHEUMATOLOGY, 2015, 54 (08) :1403-1407

[10] Long-Term Outcome of Lupus Nephritis in Asian Indians [J].

Dhir, Varun ;

Aggarwal, Amita ;

Lawrence, Able ;

Agarwal, Vikas ;

Misra, Ramnath .

ARTHRITIS CARE & RESEARCH, 2012, 64 (05) :713-720

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