西班牙人群SLEDAI和sled - das之间的强相关性：不一致患者的评估

IF 4.6 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism Pub Date : 2025-05-16 DOI:10.1016/j.semarthrit.2025.152758

Elena Heras-Recuero , Antía García-Fernández , Teresa Blázquez-Sánchez , Cristina Gómez-Moreno , Iván Ferraz-Amaro , Javier Llorca , Miguel A González-Gay

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引用次数: 0

摘要

背景：评估系统性红斑狼疮（SLE）的疾病活动性对于有效治疗至关重要。目的分析西班牙中部SLE患者SLEDAI-2 K与slei - das的相关性，分析导致疾病活动性分类不一致的因素。方法对西班牙马德里Fundación jimsamnez Díaz医院2010 - 2024年随访的324例SLE患者进行回顾性分析。从患者最近的就诊中收集数据，并使用SLEDAI-2 K和sledai - das评估疾病活动性，并分析工具之间的不一致分类。结果各疾病活动度类别的患者数量如下：缓解（临床SLEDAI-2 K =0, n = 254 [78.4%] vs.临床SLEDAI-2 K =0，不论血清学，强的松剂量为5mg /d， n = 253 [78.3%]）；低活性（SLEDAI-2 K - 1-4和强的松剂量≤5mg /天，n = 42[13.0%]与sledai - das剂量≤7.5 mg/天和≤2.48,n = 14 [4.3%]）；轻度活性(SLEDAI-2 K 1-4和强的松剂量>；5 mg/天或评分5 - 6分，n = 19[5.9%]，与强的松剂量≤2.48相比；7.5 mg/天或评分>；2.48和≤7.64,n = 46 [14.2%])；中度（SLEDAI-2 K 7 - 12 n = 7 [2.2%] vs. sledai - das >；7.64和≤9.9,n = 3 [0.9%]）；重度SLEDAI-2 K >；12 (n = 2(0.6%)和SLE-DAS祝辞9.9 n = 7[2.2%])。SLEDAI-2 K与sledai - das呈强相关性(ρ=0.970, p <；0.001)，一致性高(线性加权Kappa指数=0.7715,p <；0.001)。44例患者疾病活动度分类不一致。其中，39人仅在一个疾病活动水平上不一致。值得注意的是，在44例病例中，有37例与SLEDAI-2 K相比，sledai - das将患者分类为具有更高程度的疾病活动性。有皮肤和血液学表现的患者在疾病活动性方面更常见地不一致。结论sledai -2 K和sledai - das在西班牙人群疾病活动性评估中具有较强的相关性和较高的可重复性。然而，SLE- das提供了额外的信息，特别是在血液学和皮肤受累的患者中，能够更精确地评估SLE患者的疾病活动

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Strong correlation between SLEDAI and SLE-DAS in the Spanish population: Assessment of discordant patients

Background

Assessing disease activity in systemic lupus erythematosus (SLE) is essential for effective treatment. SLEDAI-2 K uses dichotomous items, while SLE-DAS incorporates both dichotomous and continuous variables,

Objectives

To analyze the correlation between SLEDAI-2 K and SLE-DAS in SLE patients from central Spain and analyze factors leading to discordance in disease activity classification.

Methods

Retrospective assessment of 324 SLE patients followed up from 2010 to 2024 at Madrid's Fundación Jiménez Díaz Hospital (Spain). Data were collected from the patients' most recent visits and disease activity was evaluated using SLEDAI-2 K and SLE-DAS, and discordant classifications between the tools were analyzed.

Results

The number of patients in each disease activity category was as follows: Remission (Clinical SLEDAI-2 K = 0, n = 254 [78.4 %] vs. clinical SLE-DAS =0, regardless of serology, and prednisone up to 5 mg/day, n = 253 [78.3 %]); Low activity (SLEDAI-2 K 1–4 and prednisone dose ≤ 5 mg/day, n = 42 [13.0 %] vs. SLE-DAS >0 and ≤ 2.48 with prednisone dose ≤ 7.5 mg/day, n = 14 [4.3 %]); Mild activity (SLEDAI-2 K 1–4 and prednisone dose > 5 mg/day or score 5–6, n = 19 [5.9 %] vs. SLE-DAS >0 and ≤ 2.48 with prednisone dose > 7.5 mg/day or score >2.48 and ≤7.64, n = 46 [14.2 %]); Moderate (SLEDAI-2 K 7–12 n = 7 [2.2 %] vs. SLE-DAS >7.64 and ≤9.9,n = 3 [0.9 %]); Severe SLEDAI-2 K > 12 (n = 2 [0.6 %] vs. SLE-DAS >9.9,n = 7 [2.2 %]). SLEDAI-2 K and SLE-DAS showed strong correlation (ρ=0.970, p < 0.001), with high concordance (linearly weighted Kappa index=0.7715, p < 0.001). Forty-four patients were discordant in terms of disease activity categorization. Of these, 39 were discordant at only one level of disease activity. Notably, in 37 of the 44 cases, SLE-DAS classified patients as having a higher degree of disease activity compared to SLEDAI-2 K. Patients with skin and hematological manifestations were more commonly discordant in terms of disease activity.

Conclusion

SLEDAI-2 K and SLE-DAS demonstrate a strong correlation and high reproducibility for assessing disease activity in the Spanish population. However, SLE-DAS offers additional information, particularly in patients with hematologic and skin involvement, enabling a more precise evaluation of disease activity in SLE patients

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来源期刊

Seminars in arthritis and rheumatism 医学-风湿病学

CiteScore

9.20

自引率

4.00%

发文量

176

审稿时长

46 days

期刊介绍： Seminars in Arthritis and Rheumatism provides access to the highest-quality clinical, therapeutic and translational research about arthritis, rheumatology and musculoskeletal disorders that affect the joints and connective tissue. Each bimonthly issue includes articles giving you the latest diagnostic criteria, consensus statements, systematic reviews and meta-analyses as well as clinical and translational research studies. Read this journal for the latest groundbreaking research and to gain insights from scientists and clinicians on the management and treatment of musculoskeletal and autoimmune rheumatologic diseases. The journal is of interest to rheumatologists, orthopedic surgeons, internal medicine physicians, immunologists and specialists in bone and mineral metabolism.