A framework for remission in SLE

Consensus findings from a large international task force on definitions of remission in SLE (DORIS)

Ronald van Vollenhoven, Alexandre Voskuyl, George Bertsias, Cynthia Aranow, Martin Aringer, Laurent Arnaud, Anca Askanase, Petra Balážová, Eloisa Bonfa, Hendrika Bootsma, Dimitrios Boumpas, Ian Bruce, Ricard Cervera, Ann Clarke, Cindy Coney, Nathalie Costedoat-Chalumeau, László Czirják, Ronald Derksen, Andrea Doria, Thomas Dörner & 38 others Rebecca Fischer-Betz, Ruth Fritsch-Stork, Caroline Gordon, Winfried Graninger, Noémi Györi, Frédéric Houssiau, David Isenberg, Soren Jacobsen, David Jayne, Annegret Kuhn, Veronique Le Guern, Kirsten Lerstrøm, Roger Levy, Francinne Machado-Ribeiro, Xavier Mariette, Jamil Missaykeh, Eric Morand, Marta Mosca, Murat Inanc, Sandra Navarra, Irmgard Neumann, Marzena Olesinska, Michelle Petri, Anisur Rahman, Ole Petter Rekvig, Jozef Rovensky, Yehuda Shoenfeld, Josef Smolen, Angela Tincani, Murray Urowitz, Bernadette van Leeuw, Carlos Vasconcelos, Anne Voss, Victoria P. Werth, Helena Zakharova, Asad Zoma, Matthias Schneider, Michael Ward

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69 Citations (Scopus)

Abstract

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 offand on therapy: remission offtherapy 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 =5 mg/day), maintenance immunosuppressives and/or maintenance biologics. The task force also agreed that the most appropriate outcomes (dependent variables) for testing the prognostic value (construct validity) of potential remission definitions are: death, damage, flares and measures of health-related quality of life. Conclusions The work of this international task force provides a framework for testing different definitions of remission against long-term outcomes.

Original languageEnglish
Pages (from-to)554-561
JournalAnnals of the Rheumatic Diseases
Volume76
Issue number3
DOIs
Publication statusPublished - 1 Mar 2017

Cite this

van Vollenhoven, Ronald ; Voskuyl, Alexandre ; Bertsias, George ; Aranow, Cynthia ; Aringer, Martin ; Arnaud, Laurent ; Askanase, Anca ; Balážová, Petra ; Bonfa, Eloisa ; Bootsma, Hendrika ; Boumpas, Dimitrios ; Bruce, Ian ; Cervera, Ricard ; Clarke, Ann ; Coney, Cindy ; Costedoat-Chalumeau, Nathalie ; Czirják, László ; Derksen, Ronald ; Doria, Andrea ; Dörner, Thomas ; Fischer-Betz, Rebecca ; Fritsch-Stork, Ruth ; Gordon, Caroline ; Graninger, Winfried ; Györi, Noémi ; Houssiau, Frédéric ; Isenberg, David ; Jacobsen, Soren ; Jayne, David ; Kuhn, Annegret ; Guern, Veronique Le ; Lerstrøm, Kirsten ; Levy, Roger ; Machado-Ribeiro, Francinne ; Mariette, Xavier ; Missaykeh, Jamil ; Morand, Eric ; Mosca, Marta ; Inanc, Murat ; Navarra, Sandra ; Neumann, Irmgard ; Olesinska, Marzena ; Petri, Michelle ; Rahman, Anisur ; Rekvig, Ole Petter ; Rovensky, Jozef ; Shoenfeld, Yehuda ; Smolen, Josef ; Tincani, Angela ; Urowitz, Murray ; van Leeuw, Bernadette ; Vasconcelos, Carlos ; Voss, Anne ; Werth, Victoria P. ; Zakharova, Helena ; Zoma, Asad ; Schneider, Matthias ; Ward, Michael. / A framework for remission in SLE : Consensus findings from a large international task force on definitions of remission in SLE (DORIS). In: Annals of the Rheumatic Diseases. 2017 ; Vol. 76, No. 3. pp. 554-561.
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title = "A framework for remission in SLE: Consensus findings from a large international task force on definitions of remission in SLE (DORIS)",
abstract = "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 offand on therapy: remission offtherapy 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 =5 mg/day), maintenance immunosuppressives and/or maintenance biologics. The task force also agreed that the most appropriate outcomes (dependent variables) for testing the prognostic value (construct validity) of potential remission definitions are: death, damage, flares and measures of health-related quality of life. Conclusions The work of this international task force provides a framework for testing different definitions of remission against long-term outcomes.",
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van Vollenhoven, R, Voskuyl, A, Bertsias, G, Aranow, C, Aringer, M, Arnaud, L, Askanase, A, Balážová, P, Bonfa, E, Bootsma, H, Boumpas, D, Bruce, I, Cervera, R, Clarke, A, Coney, C, Costedoat-Chalumeau, N, Czirják, L, Derksen, R, Doria, A, Dörner, T, Fischer-Betz, R, Fritsch-Stork, R, Gordon, C, Graninger, W, Györi, N, Houssiau, F, Isenberg, D, Jacobsen, S, Jayne, D, Kuhn, A, Guern, VL, Lerstrøm, K, Levy, R, Machado-Ribeiro, F, Mariette, X, Missaykeh, J, Morand, E, Mosca, M, Inanc, M, Navarra, S, Neumann, I, Olesinska, M, Petri, M, Rahman, A, Rekvig, OP, Rovensky, J, Shoenfeld, Y, Smolen, J, Tincani, A, Urowitz, M, van Leeuw, B, Vasconcelos, C, Voss, A, Werth, VP, Zakharova, H, Zoma, A, Schneider, M & Ward, M 2017, 'A framework for remission in SLE: Consensus findings from a large international task force on definitions of remission in SLE (DORIS)', Annals of the Rheumatic Diseases, vol. 76, no. 3, pp. 554-561. https://doi.org/10.1136/annrheumdis-2016-209519

A framework for remission in SLE : Consensus findings from a large international task force on definitions of remission in SLE (DORIS). / van Vollenhoven, Ronald; Voskuyl, Alexandre; Bertsias, George; Aranow, Cynthia; Aringer, Martin; Arnaud, Laurent; Askanase, Anca; Balážová, Petra; Bonfa, Eloisa; Bootsma, Hendrika; Boumpas, Dimitrios; Bruce, Ian; Cervera, Ricard; Clarke, Ann; Coney, Cindy; Costedoat-Chalumeau, Nathalie; Czirják, László; Derksen, Ronald; Doria, Andrea; Dörner, Thomas; Fischer-Betz, Rebecca; Fritsch-Stork, Ruth; Gordon, Caroline; Graninger, Winfried; Györi, Noémi; Houssiau, Frédéric; Isenberg, David; Jacobsen, Soren; Jayne, David; Kuhn, Annegret; Guern, Veronique Le; Lerstrøm, Kirsten; Levy, Roger; Machado-Ribeiro, Francinne; Mariette, Xavier; Missaykeh, Jamil; Morand, Eric; Mosca, Marta; Inanc, Murat; Navarra, Sandra; Neumann, Irmgard; Olesinska, Marzena; Petri, Michelle; Rahman, Anisur; Rekvig, Ole Petter; Rovensky, Jozef; Shoenfeld, Yehuda; Smolen, Josef; Tincani, Angela; Urowitz, Murray; van Leeuw, Bernadette; Vasconcelos, Carlos; Voss, Anne; Werth, Victoria P.; Zakharova, Helena; Zoma, Asad; Schneider, Matthias; Ward, Michael.

In: Annals of the Rheumatic Diseases, Vol. 76, No. 3, 01.03.2017, p. 554-561.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - A framework for remission in SLE

T2 - Consensus findings from a large international task force on definitions of remission in SLE (DORIS)

AU - van Vollenhoven, Ronald

AU - Voskuyl, Alexandre

AU - Bertsias, George

AU - Aranow, Cynthia

AU - Aringer, Martin

AU - Arnaud, Laurent

AU - Askanase, Anca

AU - Balážová, Petra

AU - Bonfa, Eloisa

AU - Bootsma, Hendrika

AU - Boumpas, Dimitrios

AU - Bruce, Ian

AU - Cervera, Ricard

AU - Clarke, Ann

AU - Coney, Cindy

AU - Costedoat-Chalumeau, Nathalie

AU - Czirják, László

AU - Derksen, Ronald

AU - Doria, Andrea

AU - Dörner, Thomas

AU - Fischer-Betz, Rebecca

AU - Fritsch-Stork, Ruth

AU - Gordon, Caroline

AU - Graninger, Winfried

AU - Györi, Noémi

AU - Houssiau, Frédéric

AU - Isenberg, David

AU - Jacobsen, Soren

AU - Jayne, David

AU - Kuhn, Annegret

AU - Guern, Veronique Le

AU - Lerstrøm, Kirsten

AU - Levy, Roger

AU - Machado-Ribeiro, Francinne

AU - Mariette, Xavier

AU - Missaykeh, Jamil

AU - Morand, Eric

AU - Mosca, Marta

AU - Inanc, Murat

AU - Navarra, Sandra

AU - Neumann, Irmgard

AU - Olesinska, Marzena

AU - Petri, Michelle

AU - Rahman, Anisur

AU - Rekvig, Ole Petter

AU - Rovensky, Jozef

AU - Shoenfeld, Yehuda

AU - Smolen, Josef

AU - Tincani, Angela

AU - Urowitz, Murray

AU - van Leeuw, Bernadette

AU - Vasconcelos, Carlos

AU - Voss, Anne

AU - Werth, Victoria P.

AU - Zakharova, Helena

AU - Zoma, Asad

AU - Schneider, Matthias

AU - Ward, Michael

PY - 2017/3/1

Y1 - 2017/3/1

N2 - 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 offand on therapy: remission offtherapy 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 =5 mg/day), maintenance immunosuppressives and/or maintenance biologics. The task force also agreed that the most appropriate outcomes (dependent variables) for testing the prognostic value (construct validity) of potential remission definitions are: death, damage, flares and measures of health-related quality of life. Conclusions The work of this international task force provides a framework for testing different definitions of remission against long-term outcomes.

AB - 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 offand on therapy: remission offtherapy 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 =5 mg/day), maintenance immunosuppressives and/or maintenance biologics. The task force also agreed that the most appropriate outcomes (dependent variables) for testing the prognostic value (construct validity) of potential remission definitions are: death, damage, flares and measures of health-related quality of life. Conclusions The work of this international task force provides a framework for testing different definitions of remission against long-term outcomes.

UR - http://www.scopus.com/inward/record.url?scp=85006051899&partnerID=8YFLogxK

U2 - 10.1136/annrheumdis-2016-209519

DO - 10.1136/annrheumdis-2016-209519

M3 - Article

VL - 76

SP - 554

EP - 561

JO - Annals of the Rheumatic Diseases

JF - Annals of the Rheumatic Diseases

SN - 0003-4967

IS - 3

ER -