Does remission in systemic lupus erythematosus according to the 2021 DORIS definition match the treating rheumatologist's judgement?

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• dc.contributor.author Altabás-González, Irene
• dc.contributor.author Rúa-Figueroa, Iñigo
• dc.contributor.author Rubiño, Francisco
• dc.contributor.author Mouriño Rodríguez, Coral
• dc.contributor.author Hernández-Rodríguez, Iñigo
• dc.contributor.author Menor Almagro, Raul
• dc.contributor.author Uriarte Isacelaya, Esther
• dc.contributor.author Tomero Muriel, Eva
• dc.contributor.author Salman-Monte, Tarek Carlos
• dc.contributor.author Carrión-Barberà, María Irene
• dc.contributor.author Galindo-Izquierdo, Maria
• dc.contributor.author Rodríguez Almaraz, M. Esther
• dc.contributor.author Inês, Luis S.
• dc.contributor.author Jiménez, Norman
• dc.contributor.author Pego-Reigosa, José Maria
• dc.date.accessioned 2024-04-11T05:46:54Z
• dc.date.available 2024-04-11T05:46:54Z
• dc.date.issued 2024
• dc.description.abstract Objectives: To assess agreement between the 2021 Definition Of Remission In SLE (DORIS) and physician-judged lupus activity. Methods: A cross-sectional analysis was conducted of data from a Spanish prospective multicentre study of SLE patients. We applied the 2021 DORIS criteria and assessed whether remission status based on this definition agreed with remission as per physician clinical judgement and reasons for disagreement between them. Results: Out of 508 patients [92% women; mean age (s.d.): 50.4 years (13.7)] studied, 267 (54.4%) met the criteria for 2021 DORIS remission. Based on physicians' judgement, 277 (55.9%) patients were classified as in remission or serologically active clinically quiescent (SACQ). The overall rate of agreement between these assessments was 81.2% (95% CI: 79.9, 82.9%) with a Cohen's kappa of 0.62 (0.55-0.69). Overall, 46 (9.1%) patients were classified as in remission/SACQ by rheumatologists but did not meet the 2021 DORIS criteria for remission. The main reasons for discrepancies were a clinical SLE Disease Activity Index (cSLEDAI) score >0 in 39 patients, a Physician Global Assessment score >0.5 in five patients, and prednisone >5 mg/day in another five patients. Conclusions: The 2021 DORIS remission is an achievable target in clinical practice. There is substantial agreement between the DORIS definition and physician-judged remission. The discordance was mainly due to physicians classifying some patients with ongoing mild disease activity as in remission. Thus, the standardized DORIS definition should be used to define the target in a treat-to-target strategy for the management of SLE.
• dc.format.mimetype application/pdf
• dc.identifier.citation Altabás-González I, Rúa-Figueroa Í, Rubiño F, Mouriño C, Hernández-Rodriguez Í, Menor-Almagro R, et al. Does remission in systemic lupus erythematosus according to the 2021 DORIS definition match the treating rheumatologist's judgement?. Rheumatology (Oxford). 2024 Jan 4;63(1):72-8. DOI: 10.1093/rheumatology/kead159
• dc.identifier.doi http://dx.doi.org/10.1093/rheumatology/kead159
• dc.identifier.issn 1462-0324
• dc.identifier.uri http://hdl.handle.net/10230/59729
• dc.language.iso eng
• dc.publisher Oxford University Press
• dc.relation.ispartof Rheumatology (Oxford). 2024 Jan 4;63(1):72-8
• dc.rights © The Author(s) 2023. Published by Oxford University Press on behalf of the British Society for Rheumatology. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by/4.0/
• dc.subject.keyword DORIS
• dc.subject.keyword SLE
• dc.subject.keyword Spanish
• dc.subject.keyword Cohort
• dc.subject.keyword Disease activity
• dc.subject.keyword Multicentre
• dc.subject.keyword Remission
• dc.subject.keyword Target
• dc.title Does remission in systemic lupus erythematosus according to the 2021 DORIS definition match the treating rheumatologist's judgement?
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion