Franklyn et al reported the Lupus Low Disease Activity State (LLDAS) for patients with systemic lupus erythematosus (SLE). This can help guide management of the patient. The authors are from multiple institutions in Asia and the Pacific participating in the Asia-Pacific Lupus Collaboration.
Patient selection: SLE
Parameters:
(1) SLEDAI-2000 (SLEDAI-2K)
(2) new features of lupus disease activity, as compared to previous evaluation
(3) physican global assessment (PGA) from the SELENA-SLEDAI tool, from 0 to 3
(4) current prednisolone equivalent dose in mg per day
(5) toleration of standard maintenance doses of immunosuppressive drugs and approved biological agents (excluding investigational drugs)
|
Parameter
|
Finding
|
Points
|
|
SLEDAI-2K
|
0 to 4, without clinical findings (see below)
|
1
|
|
|
> 4 or clinical finding
|
0
|
|
new features of disease activity
|
none
|
1
|
|
|
any
|
0
|
|
PGA
|
0 or 1
|
1
|
|
|
2 or 3
|
0
|
|
prednisolone equivalent
|
<= 7.5 mg
|
1
|
|
|
> 7.5 mg
|
0
|
|
tolerance of maintenance therapy
|
well-tolerated
|
1
|
|
|
not well-tolerated
|
0
|
For a patient with LLDAS, the SLEDAI-2000 should demonstrate:
(1) no renal activity
(2) no CNS activity
(3) no cardiopulmonary activity
(4) no vasculitis
(5) no fever
(6) no hemolytic anemia
(7) no gastrointestinal activity
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 5
• A score of 5 indicates the presence of LLDAS.
