Altabás-González, IreneRúa-Figueroa, IñigoRubiño, FranciscoMouriño Rodríguez, CoralHernández-Rodríguez, IñigoMenor Almagro, RaulUriarte Isacelaya, EstherTomero Muriel, EvaSalman-Monte, Tarek CarlosCarrión-Barberà, María IreneGalindo, MariaRodríguez Almaraz, Esther M.Jiménez, NormanInês, Luis S.Pego-Reigosa, José Maria2023-02-142023-02-142023Altabás-González I, Rúa-Figueroa I, Rubiño F, Rodríguez CM, Hernández-Rodríguez I, Menor Almagro R, Isacelaya EU, Muriel ET, Salman-Monte TC, Carrión-Barberà I, Galindo M, Almaraz EMR, Jiménez N, Inês L, Pego-Reigosa JM. Does expert opinion match the definition of Lupus Low Disease Activity State? prospective analysis of 500 patients from a Spanish multicentre cohort. Rheumatology (Oxford). 2023 Mar 1;62(3):1162-9. DOI: 10.1093/rheumatology/keac4621462-0324http://hdl.handle.net/10230/55751Objectives: To apply Lupus Low Disease Activity State (LLDAS) definition within a large cohort of patients and to assess the agreement between the LLDAS and the physician's subjective evaluation of lupus activity. Methods: A cross-sectional analysis of a prospective multicentre study of Systemic Lupus Erythematosus (SLE) patients. We applied the LLDAS and assessed whether there was agreement with the clinical status according to the physiciańs opinion. Results: 508 patients (92% women; mean age (±SD): 50.4 years (± 13.7)). A total of 304 (62.7%) patients were in LLDAS. According to physician assessment, 430 patients (86,1%) were classified as remission or low activity. Overall agreement between both evaluations was 71.4% (95% CI: 70.1-70.5%) with a Coheńs kappa of 0.3 (0.22-0.37). Most cases (96.1%) in LLDAS were classified as remission or low activity by the expert. Of the patients that did not fulfill LLDAS, 126 (70.4%) were classified as having remission/low disease activity. The main reasons for these discrepancies were the presence of new manifestations compared with the previous visit and a SLEDAI 2-K > 4, mainly based on serological activity. Conclusions: Almost two thirds of SLE patients were in LLDAS. There was a fair correlation between LLDAS and the physician's evaluation. This agreement improves for patients fulfilling the LLDAS criteria. The discordance between both at defining lupus low activity, the demonstrated association of LLDAS with better outcomes and the fact that LLDAS is more stringent than physician's opinion imply that we should use the LLDAS as a treat to target goal.application/pdfeng© The Author(s) 2022. 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-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.cominfo:eu-repo/semantics/articlehttp://dx.doi.org/10.1093/rheumatology/keac462DORISLLDASSpanishSystemic lupus erythematosusCohortDisease activityLow activityMulticentreRemissionTargetinfo:eu-repo/semantics/openAccess