Definition of Low Disease Activity State based on the SLE-DAS: Derivation and validation in a multicentre real-life cohort
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.19/7406 |
Resumo: | Objectives To derive and validate a definition of low disease activity (LDA) for SLE based on the SLE Disease Activity Score (SLE-DAS), in a real-life multicentre cohort of SLE patients. Methods Derivation was conducted using data from a monocentric cohort of SLE (Portugal), and validation was performed in a multicentre cohort (Italy, France and Spain). The Lupus Low Disease Activity State (LLDAS) was used as comparator. We applied receiver operating characteristics curve analysis against the LLDAS to determine the cut-off of SLE-DAS for LDA using bootstrap methodology. In a second step, we tested a definition of SLE-DAS LDA that included: (i) the statistically derived SLE-DAS upper threshold for LDA and (ii) prednisone dose ≤7.5 mg/day. In the multicentre validation cohort, we assessed the classification performance of this SLE-DAS LDA definition. Results We included 774 patients, 300 in the derivation and 474 in the validation cohort. In the derivation cohort, the optimal cut-off to identify patients in LLDAS was SLE-DAS ≤2.48, presenting an area under the curve of 0.965 (95% CI 0.935, 0.994). When applied to the multicentre validation cohort, the SLE-DAS LDA definition showed a sensitivity of 97.1% and a specificity of 97.7% for LLDAS and an almost perfect agreement (Cohen’s Kappa = 0.933; P < 0.001). McNemar’s test found no significant differences between the two definitions (P = 0.092). Conclusion The SLE-DAS LDA is a validated, accurate and easy-to-use definition for classifying SLE patients in LDA state. |
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Definition of Low Disease Activity State based on the SLE-DAS: Derivation and validation in a multicentre real-life cohortsystemic lupus erythematosustreat-to-targetSLE-DASLLDASObjectives To derive and validate a definition of low disease activity (LDA) for SLE based on the SLE Disease Activity Score (SLE-DAS), in a real-life multicentre cohort of SLE patients. Methods Derivation was conducted using data from a monocentric cohort of SLE (Portugal), and validation was performed in a multicentre cohort (Italy, France and Spain). The Lupus Low Disease Activity State (LLDAS) was used as comparator. We applied receiver operating characteristics curve analysis against the LLDAS to determine the cut-off of SLE-DAS for LDA using bootstrap methodology. In a second step, we tested a definition of SLE-DAS LDA that included: (i) the statistically derived SLE-DAS upper threshold for LDA and (ii) prednisone dose ≤7.5 mg/day. In the multicentre validation cohort, we assessed the classification performance of this SLE-DAS LDA definition. Results We included 774 patients, 300 in the derivation and 474 in the validation cohort. In the derivation cohort, the optimal cut-off to identify patients in LLDAS was SLE-DAS ≤2.48, presenting an area under the curve of 0.965 (95% CI 0.935, 0.994). When applied to the multicentre validation cohort, the SLE-DAS LDA definition showed a sensitivity of 97.1% and a specificity of 97.7% for LLDAS and an almost perfect agreement (Cohen’s Kappa = 0.933; P < 0.001). McNemar’s test found no significant differences between the two definitions (P = 0.092). Conclusion The SLE-DAS LDA is a validated, accurate and easy-to-use definition for classifying SLE patients in LDA state.Repositório Científico do Instituto Politécnico de ViseuAssunção, HelenaJesus, DiogoLarosa, MaddalenaHenriques, CarlaMatos, AnaLe Guern, VéroniqueRubiño, FranciscoSilva, José A P daRua-Figueroa, IñigoCostedoat-Chalumeau, NathalieDoria, AndreaInês, Luís S2022-11-18T11:08:46Z2022-08-032022-11-16T18:31:14Z2022-08-03T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.19/7406eng1462-0324cv-prod-263000010.1093/rheumatology/keab895metadata only accessinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-01-16T15:29:34Zoai:repositorio.ipv.pt:10400.19/7406Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:45:08.618097Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Definition of Low Disease Activity State based on the SLE-DAS: Derivation and validation in a multicentre real-life cohort |
title |
Definition of Low Disease Activity State based on the SLE-DAS: Derivation and validation in a multicentre real-life cohort |
spellingShingle |
Definition of Low Disease Activity State based on the SLE-DAS: Derivation and validation in a multicentre real-life cohort Assunção, Helena systemic lupus erythematosus treat-to-target SLE-DAS LLDAS |
title_short |
Definition of Low Disease Activity State based on the SLE-DAS: Derivation and validation in a multicentre real-life cohort |
title_full |
Definition of Low Disease Activity State based on the SLE-DAS: Derivation and validation in a multicentre real-life cohort |
title_fullStr |
Definition of Low Disease Activity State based on the SLE-DAS: Derivation and validation in a multicentre real-life cohort |
title_full_unstemmed |
Definition of Low Disease Activity State based on the SLE-DAS: Derivation and validation in a multicentre real-life cohort |
title_sort |
Definition of Low Disease Activity State based on the SLE-DAS: Derivation and validation in a multicentre real-life cohort |
author |
Assunção, Helena |
author_facet |
Assunção, Helena Jesus, Diogo Larosa, Maddalena Henriques, Carla Matos, Ana Le Guern, Véronique Rubiño, Francisco Silva, José A P da Rua-Figueroa, Iñigo Costedoat-Chalumeau, Nathalie Doria, Andrea Inês, Luís S |
author_role |
author |
author2 |
Jesus, Diogo Larosa, Maddalena Henriques, Carla Matos, Ana Le Guern, Véronique Rubiño, Francisco Silva, José A P da Rua-Figueroa, Iñigo Costedoat-Chalumeau, Nathalie Doria, Andrea Inês, Luís S |
author2_role |
author author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Repositório Científico do Instituto Politécnico de Viseu |
dc.contributor.author.fl_str_mv |
Assunção, Helena Jesus, Diogo Larosa, Maddalena Henriques, Carla Matos, Ana Le Guern, Véronique Rubiño, Francisco Silva, José A P da Rua-Figueroa, Iñigo Costedoat-Chalumeau, Nathalie Doria, Andrea Inês, Luís S |
dc.subject.por.fl_str_mv |
systemic lupus erythematosus treat-to-target SLE-DAS LLDAS |
topic |
systemic lupus erythematosus treat-to-target SLE-DAS LLDAS |
description |
Objectives To derive and validate a definition of low disease activity (LDA) for SLE based on the SLE Disease Activity Score (SLE-DAS), in a real-life multicentre cohort of SLE patients. Methods Derivation was conducted using data from a monocentric cohort of SLE (Portugal), and validation was performed in a multicentre cohort (Italy, France and Spain). The Lupus Low Disease Activity State (LLDAS) was used as comparator. We applied receiver operating characteristics curve analysis against the LLDAS to determine the cut-off of SLE-DAS for LDA using bootstrap methodology. In a second step, we tested a definition of SLE-DAS LDA that included: (i) the statistically derived SLE-DAS upper threshold for LDA and (ii) prednisone dose ≤7.5 mg/day. In the multicentre validation cohort, we assessed the classification performance of this SLE-DAS LDA definition. Results We included 774 patients, 300 in the derivation and 474 in the validation cohort. In the derivation cohort, the optimal cut-off to identify patients in LLDAS was SLE-DAS ≤2.48, presenting an area under the curve of 0.965 (95% CI 0.935, 0.994). When applied to the multicentre validation cohort, the SLE-DAS LDA definition showed a sensitivity of 97.1% and a specificity of 97.7% for LLDAS and an almost perfect agreement (Cohen’s Kappa = 0.933; P < 0.001). McNemar’s test found no significant differences between the two definitions (P = 0.092). Conclusion The SLE-DAS LDA is a validated, accurate and easy-to-use definition for classifying SLE patients in LDA state. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-11-18T11:08:46Z 2022-08-03 2022-11-16T18:31:14Z 2022-08-03T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.19/7406 |
url |
http://hdl.handle.net/10400.19/7406 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
1462-0324 cv-prod-2630000 10.1093/rheumatology/keab895 |
dc.rights.driver.fl_str_mv |
metadata only access info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
metadata only access |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.source.none.fl_str_mv |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799130922778361856 |