Skip to main content

Disease activity, outcomes, prognosis, and perspectives

  • Chapter
  • First Online:
Advanced Handbook of Systemic Lupus Erythematosus

Abstract

The concept of disease activity in systemic lupus erythematosus (SLE) is fairly intuitive and most clinicians are used to thinking of their patient’s condition as representing, at any given point in time, a high, moderate, or low disease activity, or even a remission: the complete absence of disease activity. However, behind these deceptively simple statements hides a complex multi-dimensional reality, where the specific clinical manifestations attributed to SLE, the subjective experiences of the patient, and treatments all interact (Figure 8.1). Considerable efforts have been made over the past several decades to arrive at standardized and quantitative measures of disease activity both for some of the individual SLE manifestations and for the overall disease.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 54.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 69.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • 1 Petri M, Kasitanon N, Lee SS, et al. Systemic lupus international collaborating clinics renal activity/response exercise: development of a renal activity score and renal response index. Arthritis Rheum. 2008;58:1784–1788.

    Google Scholar 

  • 2 Weening JJ, D’Agati VD, Schwartz MM, et al. The classification of glomerulonephritis in systemic lupus erythematosus revisited. J Am Soc Nephrol. 2004;15:241–250.

    Google Scholar 

  • 3 Gunnarsson I, Sundelin B, Heimburger M, et al. Repeated renal biopsy in proliferative lupus nephritis--predictive role of serum C1q and albuminuria. J Rheumatol. 2002;29:693–699.

    Google Scholar 

  • 4 Parikh SV, Malvar A, Song H, et al. Characterising the immune profile of the kidney biopsy at lupus nephritis flare differentiates early treatment responders from non-responders. Lupus Sci Med. 2015;2:e000112.

    Google Scholar 

  • 5 Albrecht J, Taylor L, Berlin JA, et al. The CLASI (Cutaneous Lupus Erythematosus Disease Area and Severity Index): an outcome instrument for cutaneous lupus erythematosus. J Invest Dermatol. 2005;125:889–894.

    Google Scholar 

  • 6 Khamashta M, Merrill JT, Werth VP, et al. Sifalimumab, an anti-interferon-alpha monoclonal antibody, in moderate to severe systemic lupus erythematosus: a randomised, double-blind, placebo-controlled study. Ann Rheum Dis. 2016;75:1909–1916.

    Google Scholar 

  • 7 Kuhn A, Meuth AM, Bein D, et al. Revised Cutaneous Lupus Erythematosus Disease Area and Severity Index (RCLASI): a modified outcome instrument for cutaneous lupus erythematosus. Br J Dermatol. 2010;163:83–92.

    Google Scholar 

  • 8 Bombardier C, Gladman DD, Urowitz MB, Caron D, Chang CH. Derivation of the SLEDAI. A disease activity index for lupus patients. The Committee on Prognosis Studies in SLE. Arthritis Rheum. 1992;35:630–640.

    Google Scholar 

  • 9 Gladman DD, Ibanez D, Urowitz MB. Systemic lupus erythematosus disease activity index 2000. J Rheumatol. 2002;29:288–291.

    Google Scholar 

  • 10 Buyon JP, Petri MA, Kim MY, et al. The effect of combined estrogen and progesterone hormone replacement therapy on disease activity in systemic lupus erythematosus: a randomized trial. Ann Intern Med. 2005;142:953–962.

    Google Scholar 

  • 11 Symmons DP, Coppock JS, Bacon PA, et al. Development and assessment of a computerized index of clinical disease activity in systemic lupus erythematosus. Members of the British Isles Lupus Assessment Group (BILAG). Q J Med. 1988;69:927–937.

    Google Scholar 

  • 12 Isenberg DA, Rahman A, Allen E, et al. BILAG 2004. Development and initial validation of an updated version of the British Isles Lupus Assessment Group’s disease activity index for patients with systemic lupus erythematosus. Rheumatology (Oxford). 2005;44:902–906.

    Google Scholar 

  • 13 Navarra SV, Guzman RM, Gallacher AE, et al. Efficacy and safety of belimumab in patients with active systemic lupus erythematosus: a randomised, placebo-controlled, phase 3 trial. Lancet. 2011;377:721–731.

    Google Scholar 

  • 14 Furie R, Petri M, Zamani O, et al. A phase III, randomized, placebo-controlled study of belimumab, a monoclonal antibody that inhibits B lymphocyte stimulator, in patients with systemic lupus erythematosus. Arthritis Rheum. 2011;63:3918–3930.

    Google Scholar 

  • 15 Vitali C, Bencivelli W, Isenberg DA, et al. Disease activity in systemic lupus erythematosus: report of the Consensus Study Group of the European Workshop for Rheumatology Research. I. A descriptive analysis of 704 European lupus patients. European Consensus Study Group for Disease Activity in SLE. Clin Exp Rheumatol. 1992;10:527–539.

    Google Scholar 

  • 16 Mosca M, Bencivelli W, Vitali C, Carrai P, Neri R, Bombardieri S. The validity of the ECLAM index for the retrospective evaluation of disease activity in systemic lupus erythematosus. Lupus. 2000;9:445–450.

    Google Scholar 

  • 17 Petri M, Hellmann D, Hochberg M. Validity and reliability of lupus activity measures in the routine clinic setting. J Rheumatol. 1992;19:53–59.

    Google Scholar 

  • 18 Liang MH, Socher SA, Larson MG, Schur PH. Reliability and validity of six systems for the clinical assessment of disease activity in systemic lupus erythematosus. Arthritis Rheum. 1989;32:1107–1118.

    Google Scholar 

  • 19 Petri MA, Lahita RG, Van Vollenhoven RF, et al. Effects of prasterone on corticosteroid requirements of women with systemic lupus erythematosus: a double-blind, randomized, placebo-controlled trial. Arthritis Rheum. 2002;46:1820–1829.

    Google Scholar 

  • 20 Petri MA, Mease PJ, Merrill JT, et al. Effects of prasterone on disease activity and symptoms in women with active systemic lupus erythematosus. Arthritis Rheum 2004;50:2858–2868.

    Google Scholar 

  • 21 Karlson EW, Daltroy LH, Rivest C, et al. Validation of a Systemic Lupus Activity Questionnaire (SLAQ) for population studies. Lupus. 2003;12:280–286.

    Google Scholar 

  • 22 Touma Z, Gladman DD, Ibanez D, Urowitz MB. Development and initial validation of the systemic lupus erythematosus disease activity index 2000 responder index 50. J Rheumatol. 2011;38:275–284.

    Google Scholar 

  • 23 Franklyn K, Lau CS, Navarra SV, et al. Definition and initial validation of a Lupus Low Disease Activity State (LLDAS). Ann Rheum Dis 2016;75:1615–1621.

    Google Scholar 

  • 24 van Vollenhoven R, Voskuyl A, Bertsias G, et al. A framework for remission in SLE: consensus findings from a large international task force on definitions of remission in SLE (DORIS). Ann Rheum Dis. 2017;76:554–561.

    Google Scholar 

  • 25 Gladman D, Ginzler E, Goldsmith C, et al. The development and initial validation of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index for systemic lupus erythematosus. Arthritis Rheum. 1996;39:363–369.

    Google Scholar 

  • 26 Nived O, Jonsen A, Bengtsson AA, Bengtsson C, Sturfelt G. High predictive value of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index for survival in systemic lupus erythematosus. J Rheumatol. 2002;29:1398–1400.

    Google Scholar 

  • 27 Castrejon I, Carmona L, Agrinier N, et al. The EULAR Outcome Measures Library: development and an example from a systematic review for systemic lupus erythematous instruments. Clin Exp Rheumatol. 2015;33:910–916.

    Google Scholar 

  • 28 Houssiau FA, Vasconcelos C, D’Cruz D, et al. The 10-year follow-up data of the Euro-Lupus Nephritis Trial comparing low-dose and high-dose intravenous cyclophosphamide. Ann Rheum Dis. 2010;69:61–64.

    Google Scholar 

  • 29 Bexelius C, Wachtmeister K, Skare P, Jonsson L, Vollenhoven R. Drivers of cost and health-related quality of life in patients with systemic lupus erythematosus (SLE): a Swedish nationwide study based on patient reports. Lupus. 2013;22:793–801.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Laurent Arnaud .

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Arnaud, L., van Vollenhoven, R. (2018). Disease activity, outcomes, prognosis, and perspectives. In: Advanced Handbook of Systemic Lupus Erythematosus. Adis, Cham. https://doi.org/10.1007/978-3-319-43035-5_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-43035-5_8

  • Published:

  • Publisher Name: Adis, Cham

  • Print ISBN: 978-3-319-43034-8

  • Online ISBN: 978-3-319-43035-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics