Sensitivity of the systemic lupus erythematosus disease activity index, British Isles lupus assessment group index, and systemic lupus activity measure in the evaluation of clinical change in childhood-onset systemic lupus erythematosus
Sensitivity of the systemic lupus erythematosus disease activity index, British Isles lupus assessment group index, and systemic lupus activity measure in the evaluation of clinical change in childhood-onset systemic lupus erythematosus
复制标题
DOI：
10.1002/1529-0131(199907)42:7
复制
发表时间：
1999-07-01
影响因子：
--
通讯作者：
Silverman, ED
中科院分区：
文献类型：
--
作者：
Brunner, HI;Feldman, BM;Silverman, ED
Objective.目的探讨3种常用于评价成人系统性红斑狼疮（SLE）的疾病活动指数对儿童SLE的临床变化是否敏感，是否适合用于儿童期SLE的治疗。回顾了1993年至1997年间新诊断的35例SLE患者，发病年龄6-16岁（26例女性和9例男性），目前正在患病儿童医院接受随访（随访9个月至4年）。SLEDAI（系统性红斑狼疮疾病活动指数），BILAG（不列颠群岛狼疮评估组指数），和SLAM（系统性狼疮活动测量）在疾病过程中最多应用4次：在诊断时，诊断后6个月，在耀斑爆发时（临床表现或实验室结果恶化，需要开始或增加皮质类固醇或“二线”药物），和爆发后6个月。以效应量（ES）、效应量指数（ESI）、标准反应均数（SRM）、反应性统计量（RS）和相对效率指数（REI）为指标，比较3种方法对疾病活动性变化的敏感性（ES >0.8，ESI >2.3，SRM >0.6，RS >0.86，REI >0.72），但根据用于比较的统计量而排名不同。所有3种疾病活动性指标对儿童的临床变化高度敏感;没有一种指标显示出总体优效性。SLEDAI、BILAG和SLAM均可用于研究SLE儿童对治疗的反应。
Objective. To investigate whether 3 disease activity indices commonly used to evaluate systemic lupus erythematosus (SLE) in adults are sensitive to clinical change in children, and thus suitable for the use in the management of childhood-onset SLE.Methods. Thirty-five SLE patients who were newly diagnosed between 1993 and 1997, had an age at onset of 6-16 years (26 female and 9 male), and were currently being followed up at The Hospital for Sick Children (followup of 9 months to 4 years) were reviewed. The SLEDAI (Systemic Lupus Erythematosus Disease Activity Index), BILAG (British Isles Lupus Assessment Group index), and SLAM (Systemic Lupus Activity measure) were applied at up to 4 occasions during the disease course: at the time of diagnosis, 6 months postdiagnosis, at the time of a flare (a deterioration in clinical presentation or laboratory results requiring initiation or increase of either corticosteroids or "second-line" drugs), and 6 months postflare. The sensitivity of the 3 measures to change, as gauged by the effect size (ES), effect size index (ESI), standard response mean (SRM), responsiveness statistic (RS), and relative efficiency index (REI), were compared.Results, All 3 tools were very sensitive to change in disease activity (ES >0.8, ESI >2.3, SRM >0.6, RS >0.86, REI >0.72), but were ranked differently depending on the statistic used for comparison.Conclusion. All 3 measures of disease activity are highly sensitive to clinical change in children; none showed an overall superiority. The SLEDAI, BILAG, and SLAM can ail be used to study response to treatment in children with SLE.