Performance of the systemic lupus erythematosus disease activity score (SLE-DAS) in daily clinical practice: A prospective study of 125 patients in India
Ritasman Baisya, Kaushik Mukhopadhyay, Sukdev Manna, Luís Sousa InêsBackground
Accurate measurement of disease activity is a cornerstone in the management of patients with Systemic Lupus Erythematosus (SLE), to assist in guiding therapeutic decisions. SLE-DAS (SLE Disease Activity Score) is designed to improve accuracy and sensitivity to change compared with the standard SLE Disease Activity Index (SLEDAI) score.
Objectives
We aimed to assess the performance of SLE-DAS to identify flare and clinically meaningful improvement (CMI) in real-life SLE patients in India.
Methods
Prospective observational study at an Indian Rheumatology Clinic included SLE patients meeting 2012 SLICC and/or 2019 ACR/EULAR criteria, followed for 9 months. At baseline and subsequent follow-up, we recorded SLEDAI-2K, SLE-DAS, PGA, LLDAS, DORIS remission, prednisolone dose, and immunosuppressives; SELENA-SLEDAI flare index (SFI) was evaluated at follow-up. We assessed Spearman correlation, agreement, and discrepancies between SLEDAI and SLE-DAS for flare and improvement detection using an agreement matrix.
Results
A strong correlation was observed between SLEDAI-2K and SLE-DAS (rho = 0.954, 95% CI 0.934–0.968,
Conclusion
SLE-DAS demonstrated superior sensitivity, granularity, and remission alignment compared to SLEDAI-2K, supporting its adoption as a primary clinical index in diverse real-world lupus practices.