Correlation between the Modified Systemic Lupus Erythematosus Disease Activity Index 2000 and the European Consensus Lupus Activity Measurement in juvenile systemic lupus erythematosus

Abstract

Objective

The objective of this study was to assess Modified Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) and European Consensus Lupus Activity Measurement (ECLAM) disease activity correlation in addition to their respective correlation to Pediatric Systemic Lupus International Collaborative Clinics/American College of Rheumatology (SLICC/ACR) Damage Index (Ped-SDI), in juvenile systemic lupus erythematosus (JSLE).

Methods

The activity indices were scored retrospectively and summarized by adjusted means during follow-up. The Ped-SDI was scored during the last visit for those with more than six months follow-up. Pearson correlation between the Modified SLEDAI-2K and ECLAM, as well as Spearman correlations between the Modified SLEDAI-2K, ECLAM, and Ped-SDI were calculated. The receiver operating characteristic (ROC) curve was calculated for both activity indices discriminating damage measured by Ped-SDI.

Results

Thirty-seven patients with mean age at diagnosis 11 ± 2.9 years and mean follow-up time 3.2 ± 2.4 years were studied. The Modified SLEDAI-2K and ECLAM adjusted means were highly correlated (r = 0.78, p < 0.001). Similarly, Spearman correlation between the activity indices was also high (r_s > 0.7, p < 0.001), but Modified SLEDAI-2K and ECLAM correlation with Ped-SDI was only moderate. ROC analysis discriminant performance for both activity indices resulted in area under curve (AUC) of 0.74 and 0.73 for Modified SLEDAI-2K and ECLAM, respectively.

Conclusion

The high correlation found between the Modified SLEDAI-2K and ECLAM adjusted means indicated that both tools can be equally useful for longitudinal estimates of JSLE activity.

Keywords

Activity childhood-onset systemic lupus erythematosus damage ECLAM juvenile systemic lupus erythematosus Modified SLEDAI-2K

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References

Brunner

Ravelli

. Developing outcome measures for paediatric rheumatic diseases. Best Pract Res Clin Rh 2009; 23: 609–624.

Lattanzi

Consolaro

Solari

Ruperto

Martini

Ravelli

. Measures of disease activity and damage in pediatric systemic lupus erythematosus: British Isles Lupus Assessment Group (BILAG), European Consensus Lupus Activity Measurement (ECLAM), Systemic Lupus Activity Measure (SLAM), Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), Physician's Global Assessment of Disease Activity (MD Global), and Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR DI; SDI). Arthrit Care Res 2011; 63: S112–117.

Uribe

Vila

McGwin

Jr Sanchez

Reveille

Alarcon

. The Systemic Lupus Activity Measure–revised, the Mexican Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), and a modified SLEDAI-2K are adequate instruments to measure disease activity in systemic lupus erythematosus. J Rheumatol 2004; 31: 1934–1940.

Brunner

Feldman

Bombardier

Silverman

. 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. Arthritis Rheum 1999; 42: 1354–1360.

Brunner

Silverman

Bombardier

Feldman

. European Consensus Lupus Activity Measurement is sensitive to change in disease activity in childhood-onset systemic lupus erythematosus. Arthritis Rheum 2003; 49: 335–341.

Sato

Corrente

Saad-Magalhães

. Chronic active disease pattern predicts early damage in juvenile systemic lupus erythematosus. Lupus 2015; 24: 1421–1428.

Gutierrez-Suarez

Ruperto

Gastaldi

. A proposal for a pediatric version of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index based on the analysis of 1,015 patients with juvenile-onset systemic lupus erythematosus. Arthritis Rheum 2006; 54: 2989–2996.

Hochberg

. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1997; 40: 1725–1725.

Vitali

Bencivelli

Isenberg

. Disease activity in systemic lupus erythematosus: report of the Consensus Study Group of the European Workshop for Rheumatology Research. II. Identification of the variables indicative of disease activity and their use in the development of an activity score. The European Consensus Study Group for Disease Activity in SLE. Clin Exp Rheumatol 1992; 10: 541–547.

10.

Fitzgerald

Grossman

. Validity and reliability of retrospective assessment of disease activity and flare in observational cohorts of lupus patients. Lupus 1999; 8: 638–644.

11.

Mosca

Bencivelli

Vitali

Carrai

Neri

Bombardieri

. The validity of the ECLAM index for the retrospective evaluation of disease activity in systemic lupus erythematosus. Lupus 2000; 9: 445–450.

12.

Ibanez

Urowitz

Gladman

. Summarizing disease features over time: I. Adjusted mean SLEDAI derivation and application to an index of disease activity in lupus. J Rheumatol 2003; 30: 1977–1982.

13.

Bernatsky

Clarke

Abrahamowicz

Neville

Karp

Pineau

. A comparison of prospective and retrospective evaluations of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index for systemic lupus erythematosus. J Rheumatol 2005; 32: 820–823.

14.

Ibanez

Gladman

Urowitz

. Adjusted mean Systemic Lupus Erythematosus Disease Activity Index-2K is a predictor of outcome in SLE. J Rheumatol 2005; 32: 824–827.

15.

Meiorin

Pistorio

Ravelli

. Validation of the Childhood Health Assessment Questionnaire in active juvenile systemic lupus erythematosus. Arthritis Rheum 2008; 59: 1112–1119.

16.

Brunner

Silverman

Bombardier

Feldman

. Risk factors for damage in childhood-onset systemic lupus erythematosus: cumulative disease activity and medication use predict disease damage. Arthritis Rheum 2002; 46: 436–444.

17.

Bandeira

Buratti

Bartoli

. Relationship between damage accrual, disease flares and cumulative drug therapies in juvenile-onset systemic lupus erythematosus. Lupus 2006; 15: 515–520.

18.

Ravelli

Duarte-Salazar

Buratti

. Assessment of damage in juvenile-onset systemic lupus erythematosus: a multicenter cohort study. Arthritis Rheum 2003; 49: 501–507.

19.

Hollander

Sage

Greenler

. International consensus for provision of quality driven care in childhood onset Systemic Lupus Erythematosus. Arthrit Care Res 2013; 65: 1416–1423.