A framework for remission in SLE: consensus findings from a large international task force on definitions of remission in SLE (DORIS)
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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DOI：
10.1136/annrheumdis-2016-209519
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发表时间：
2017-03-01
影响因子：
27.4
通讯作者：
Ward, Michael
中科院分区：
文献类型：
--
作者：
van Vollenhoven, Ronald;Voskuyl, Alexandre;Ward, Michael
治疗目标的建议已经确定了“缓解”作为系统性红斑狼疮（SLE）的目标，但认识到，这是没有普遍接受的定义。因此，我们发起了一个过程，以达到共识的潜在定义缓解SLE.Methods一个国际工作队的60名专家和患者代表参加了准备工作，面对面的会议和后续电子投票。结果专家组就SLE缓解的8个关键性问题达成一致意见，并提出3个原则指导缓解定义的进一步发展：1.缓解的定义将措辞如下：缓解在SLE是一个持久的状态，其特征是...（参考症状、体征、常规实验室）。对于定义缓解，必须使用经过验证的指标，例如，临床系统性红斑狼疮疾病活动指数（SLEDAI）=0，仅不列颠群岛狼疮评估组（BILAG）2004 D/E，临床欧洲共识狼疮结局指标（ECLAM）=0;包括常规实验室评估，并补充医生的全球评估。3.治疗缓解和治疗缓解之间有区别：治疗缓解要求患者除维持抗疟药外不接受其他SLE治疗;治疗缓解允许患者接受稳定的维持抗疟药、低剂量皮质类固醇（泼尼松
Objectives 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.Methods 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%.Results The task force agreed on eight key statements regarding remission in SLE and three principles to guide the further development of remission definitions:1. Definitions of remission will be worded as follows: remission in SLE is a durable state characterised by ... (reference to symptoms, signs, routine labs).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.3. Distinction is made between remission off and on therapy: remission off therapy requires the patient to be on no other treatment for SLE than maintenance antimalarials; and remission on therapy allows patients to be on stable maintenance antimalarials, low-dose corticosteroids (prednisone