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van Vollenhoven, Ronald; Voskuyl, Alexandre; Bertsias, George; Aranow, Cynthia; Aringer, Martin; Arnaud, Laurent; Askanase, Anca; Balážová, Petra; Bonfa, Eloisa; Bootsma, Hendrika; Boumpas, Dimitrios; Bruce, Ian; Cervera, Ricard; Clarke, Ann; Coney, Cindy; Costedoat-Chalumeau, Nathalie; Czirják, László; Derksen, Ronald; Doria, Andrea; Dörner, Thomas; Fischer-Betz, Rebecca; Fritsch-Stork, Ruth; Gordon, Caroline; Graninger, Winfried; [...]

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

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  • Media type: E-Article
  • Title: A framework for remission in SLE: consensus findings from a large international task force on definitions of remission in SLE (DORIS)
  • Contributor: van Vollenhoven, Ronald; Voskuyl, Alexandre; Bertsias, George; Aranow, Cynthia; Aringer, Martin; Arnaud, Laurent; Askanase, Anca; Balážová, Petra; Bonfa, Eloisa; Bootsma, Hendrika; Boumpas, Dimitrios; Bruce, Ian; Cervera, Ricard; Clarke, Ann; Coney, Cindy; Costedoat-Chalumeau, Nathalie; Czirják, László; Derksen, Ronald; Doria, Andrea; Dörner, Thomas; Fischer-Betz, Rebecca; Fritsch-Stork, Ruth; Gordon, Caroline; Graninger, Winfried; [...]
  • imprint: BMJ, 2017
  • Published in: Annals of the Rheumatic Diseases
  • Language: English
  • DOI: 10.1136/annrheumdis-2016-209519
  • ISSN: 0003-4967; 1468-2060
  • Origination:
  • Footnote:
  • Description: <jats:sec><jats:title>Objectives</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>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%.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The task force agreed on eight key statements regarding remission in SLE and three principles to guide the further development of remission definitions:</jats:p><jats:p>1. Definitions of remission will be worded as follows: <jats:italic>remission in SLE is a durable state characterised by</jats:italic> …………………. (reference to symptoms, signs, routine labs).</jats:p><jats:p>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.</jats:p><jats:p>3. Distinction is made between remission off and on therapy: <jats:italic>remission off therapy</jats:italic> requires the patient to be on no other treatment for SLE than maintenance antimalarials; and <jats:italic>remission on therapy</jats:italic> allows patients to be on stable maintenance antimalarials, low-dose corticosteroids (prednisone ≤5 mg/day), maintenance immunosuppressives and/or maintenance biologics.</jats:p><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>The work of this international task force provides a framework for testing different definitions of remission against long-term outcomes.</jats:p></jats:sec>