SENSITIVITY TO CHANGE OF 3 SYSTEMIC LUPUS-ERYTHEMATOSUS DISEASE-ACTIVITY INDEXES - INTERNATIONAL VALIDATION

Objective. Three indices, the SLE Disease Activity Index (SLEDAI), the Systemic Lupus Activity Measure (SLAM) and the British Isles Lupus As sessment Group (BILAG), have been found to be reliable and valid measu res of disease activity in patients with systemic lupus erythematosus (SLE). Our aim was to investigate their use and comparative ability to assess change in disease activity over time. Methods. Clinical and la boratory features of 8 patients with SLE on each of 3 consecutive visi ts were abstracted and sent in 3 separate packages to physicians from 8 centers. The order of the patient visit summaries was randomized, an d the 3 indices rated in one of 6 specific sequences. Results. The 3 i ndices were significantly (p <0.01) correlated: SLEDAI/SLAM = 0.61, BI LAG/SLAM = 0.55, SLEDAI/BILAG = 0.35. The sequence presented, the orde r of patients and order of index scoring did not contribute significan tly (p >0.05) to the variation of any of the 3 indices. All 3 indices detected differences among patients (p <0.01). Differences between vis its were detectable with SLEDAI (p = 0.03) but not with SLAM or BILAG. Conclusion. Our study confirms that the SLEDAI, SLAM and BILAG are co mparable disease activity measures. SLEDAI appears to be sensitive to change in disease activity over time.