Advanced

An assessment of disease flare in patients with systemic lupus erythematosus: a comparison of BILAG 2004 and the flare version of SELENA

Isenberg, D. A.; Allen, E.; Farewell, V.; D'Cruz, D.; Alarcon, G. S.; Aranow, C.; Bruce, I. N.; Dooley, M. A.; Fortin, P. R. and Ginzler, E. M., et al. (2011) In Annals of the Rheumatic Diseases 70(1). p.54-59
Abstract
Aims To compare the British Isles Lupus Assessment Group (BILAG) 2004, the Safety of Estrogens in Lupus Erythematosus National Assessment (SELENA) flare index (SFI) and physician's global assessment (PGA) in assessing flares of disease activity in patients with systemic lupus erythematosus (SLE). Methods Sixteen patients with active SLE were assessed by a panel of 16 rheumatologists. The order in which the patients were seen was randomised using a 4x4 Latin square design. Each patient's flare status was determined at each assessment using the BILAG 2004 activity index; the SFI and a PGA. A group of five specialists designated each patient into severe, moderate, mild or no flare categories. Results The rate of complete agreement (95% CI) of... (More)
Aims To compare the British Isles Lupus Assessment Group (BILAG) 2004, the Safety of Estrogens in Lupus Erythematosus National Assessment (SELENA) flare index (SFI) and physician's global assessment (PGA) in assessing flares of disease activity in patients with systemic lupus erythematosus (SLE). Methods Sixteen patients with active SLE were assessed by a panel of 16 rheumatologists. The order in which the patients were seen was randomised using a 4x4 Latin square design. Each patient's flare status was determined at each assessment using the BILAG 2004 activity index; the SFI and a PGA. A group of five specialists designated each patient into severe, moderate, mild or no flare categories. Results The rate of complete agreement (95% CI) of the four individual examining physicians for any flare versus no flare was 81% (55% to 94%), 75% (49% to 90%) and 75% (49% to 90%) for the BILAG 2004 index, SELENA flare instrument and PGA, respectively. The overall agreement between flare defined by BILAG 2004 and the SFI was 81% and when type of flare was considered was 52%. Intraclass correlation coefficients (95% CI), as a measure of internal reliability, were 0.54 (0.32 to 0.78) for BILAG 2004 flare compared with 0.21 (0.08 to 0.48) for SELENA flare and 0.18 (0.06 to 0.45) for PGA. Severe flare was associated with good agreement between the indices but mild/moderate flare was much less consistent. Conclusions The assessment of flare in patients with SLE is challenging. No flare and severe flare are identifiable but further work is needed to optimise the accurate 'capture' of mild and moderate flares. (Less)
Please use this url to cite or link to this publication:
author
, et al. (More)
(Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Annals of the Rheumatic Diseases
volume
70
issue
1
pages
54 - 59
publisher
British Medical Association
external identifiers
  • wos:000285381100009
  • scopus:78650632504
ISSN
1468-2060
DOI
10.1136/ard.2010.132068
language
English
LU publication?
yes
id
d2805548-cc43-44b7-8321-6cac0c165f16 (old id 1774050)
date added to LUP
2011-02-01 09:57:58
date last changed
2017-11-05 03:50:39
@article{d2805548-cc43-44b7-8321-6cac0c165f16,
  abstract     = {Aims To compare the British Isles Lupus Assessment Group (BILAG) 2004, the Safety of Estrogens in Lupus Erythematosus National Assessment (SELENA) flare index (SFI) and physician's global assessment (PGA) in assessing flares of disease activity in patients with systemic lupus erythematosus (SLE). Methods Sixteen patients with active SLE were assessed by a panel of 16 rheumatologists. The order in which the patients were seen was randomised using a 4x4 Latin square design. Each patient's flare status was determined at each assessment using the BILAG 2004 activity index; the SFI and a PGA. A group of five specialists designated each patient into severe, moderate, mild or no flare categories. Results The rate of complete agreement (95% CI) of the four individual examining physicians for any flare versus no flare was 81% (55% to 94%), 75% (49% to 90%) and 75% (49% to 90%) for the BILAG 2004 index, SELENA flare instrument and PGA, respectively. The overall agreement between flare defined by BILAG 2004 and the SFI was 81% and when type of flare was considered was 52%. Intraclass correlation coefficients (95% CI), as a measure of internal reliability, were 0.54 (0.32 to 0.78) for BILAG 2004 flare compared with 0.21 (0.08 to 0.48) for SELENA flare and 0.18 (0.06 to 0.45) for PGA. Severe flare was associated with good agreement between the indices but mild/moderate flare was much less consistent. Conclusions The assessment of flare in patients with SLE is challenging. No flare and severe flare are identifiable but further work is needed to optimise the accurate 'capture' of mild and moderate flares.},
  author       = {Isenberg, D. A. and Allen, E. and Farewell, V. and D'Cruz, D. and Alarcon, G. S. and Aranow, C. and Bruce, I. N. and Dooley, M. A. and Fortin, P. R. and Ginzler, E. M. and Gladman, D. D. and Hanly, J. G. and Inanc, M. and Kalunian, K. and Khamashta, M. and Merrill, J. T. and Nived, Ola and Petri, M. and Ramsey-Goldman, R. and Sturfelt, Gunnar and Urowitz, M. and Wallace, D. J. and Gordon, C. and Rahman, A.},
  issn         = {1468-2060},
  language     = {eng},
  number       = {1},
  pages        = {54--59},
  publisher    = {British Medical Association},
  series       = {Annals of the Rheumatic Diseases},
  title        = {An assessment of disease flare in patients with systemic lupus erythematosus: a comparison of BILAG 2004 and the flare version of SELENA},
  url          = {http://dx.doi.org/10.1136/ard.2010.132068},
  volume       = {70},
  year         = {2011},
}