Definition and treatment of lupus flares measured by the BILAG index
Definition and treatment of lupus flares measured by the BILAG index
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DOI：
10.1093/rheumatology/keg382
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发表时间：
2003-11-01
期刊：
影响因子：
5.5
通讯作者：
Isenberg, DA
中科院分区：
文献类型：
--
作者：
Gordon, C;Sutcliffe, N;Isenberg, DA
目标。BILAG指数是狼疮疾病活跃度的临床衡量标准。它是有效、可靠和对变化敏感的。BILAG指数的评分是基于医生的治疗意图。在至少一个系统中，活动性狼疮发作被定义为新的A或B评分。这项研究的主要目的是根据设计评分系统的原则来确定狼疮发作患者是否得到了预期的治疗。其次，我们想要确定新的B分先于C的患者是否应该被认为是红肿，就像患者在D或E分之后的B分一样。在12个月的时间里，250名定期到伯明翰和伦敦的狼疮诊所就诊的患者在每次就诊时都使用BILAG指数进行评估。154例(61.6%)患者有新的A或B评分。26例(10.4%)患者出现A级耀斑。65例(26.0%)患者出现B级闪光(B级先于D级或E级)。在先前记录C分的系统中，有63例(25.2%)患者有B分。20例(77%)A型红斑患者开始或增加了类固醇激素。几乎所有(92%)获得新A评分的患者在治疗中都有所增加。在新的B评分患者中，53例(41%)的治疗有所增加，但其中75例(59%)的治疗没有改变的原因是多方面的。与先前的D或E分数相比，在先前的C分数之后出现的新的B分数的处理与先前的D或E分数没有差别。非高加索人比高加索人更容易发生狼疮发作。这些结果与设计BILAG指数的原则是一致的，并表明中度疾病爆发可以被定义为根据BILAG指数在C、D或E分数之后的新的B分数。
Objectives. The BILAG index is a clinical measure of lupus disease activity. It is valid, reliable and sensitive to change. Scoring in the BILAG index is based upon the physician's intention to treat. A flare of active lupus is defined as a new A or B score in at least one system. The main aim of this study was to determine whether patients with a lupus flare are treated as expected from the principles upon which the scoring system was devised. Secondly we wanted to establish whether patients with a new B score preceded by a C should be considered to have flared, as with patients scoring B following a D or E score.Methods. Over a 12-month period, 250 patients regularly attending lupus clinics in Birmingham and London were assessed using the BILAG index at each visit.Results. A new A or B score was observed in 154 (61.6%) patients. An A flare was observed in 26 (10.4%) patients. A B flare (in which the B score was preceded by a D or E score) was observed in 65 (26.0%) patients. There were 63 (25.2%) patients in whom there was a B score in a system in which a C score was previously recorded. Steroids were started or increased in 20 (77%) patients with an A flare. Almost all (92%) patients with a new A score had some increase in therapy. For the patients with new B scores, 53 (41%) had some increase in therapy, but multiple reasons were found for no change in therapy in 75 (59%) of these patients. There was no difference in the treatment of new B scores arising after a previous C score compared with previous D or E scores. Non-Caucasians were more likely to have a lupus flare than Caucasians.Conclusions. These results are consistent with the principles upon which the BILAG index was devised and suggest that a moderate disease flare can be defined as a new B score following a C, D or E score according to the BILAG index.