SLE severity index using only ACR criteria may be reliable

An analysis of data from patients with systemic lupus erythematosus from the Lupus Family Registry and Repository shows that the development of a disease severity index that relies solely upon American College of Rheumatology criteria may be a reliable indicator of disease activity.

Researchers studied data from 1,915 patients with systemic lupus erythematosus (SLE) in the registry at the Oklahoma Medical Research Foundation.

A lupus severity index (LSI) was developed by using a risk estimate model based on American College of Rheumatology (ACR) criteria and the use of serious immunosuppressive drugs including cyclophosphamide, mycophenolate mofetil, cyclosporine or rituximab as a proxy for disease severity. Patients who received corticosteroids alone were excluded. Complications from SLE, such as organ involvement, as well as age of onset and race, were used as weighting criteria. Renal involvement was given the highest weighting score, followed by seizures, hemolytic anemia and immunologic parameters. Lower weighting was assigned to pericarditis, pleurisy and psychosis, while arthritis and some other factors were considered to be neutral in influence.

The LSI was found to be significantly associated with disease activity and mortality, according to the research.

“This index demonstrates high predictive accuracy for severity anchored to major immunosuppressive drug use in an independent cohort, shows a strong association with mortality and exhibits certain distinctive trends that SLE severity is known to follow.” – by Shirley Pulawski

Disclosure: The researchers report the research was funded by research was supported by National Institutes of Health (GM110766, U54GM104938, P30GM103510, P30AR053483, U19A1082714 and U01AI101934) and report no relevant financial disclosures.

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Source:

Bello GA, et al. Lupus Sci Med. 2016;doi:10.1136/lupus-2015- 000136.