SLE-DAS remission and low disease activity were similarly associated with patient-reported outcomes compared with definition of remission in SLE remission and lupus low disease activity state.

Abstract

The treat-to-target (T2T) approach for SLE has recently been proposed. However, the most suitable criterion for determining remission or low disease activity (LDA) using patient-reported outcomes (PROs) remains unknown. This study aimed to compare the relationship between PROs and various remission criteria, including the definition of remission in SLE (DORIS), SLE disease activity score (SLE-DAS) remission, lupus low disease activity state (LLDAS) and SLE-DAS LDA. A multicentre prospective study was conducted involving patients with SLE who visited Juntendo University and its affiliated hospitals between 2018 and 2024. A cross-sectional analysis was performed using surveys completed by physicians and patients. Multivariate analyses were performed to explore the relationship between PROs and remission/LDA criteria. Quality of life was evaluated using the medical outcomes study 36-item short-form health survey (SF-36) and EuroQol-5D. This study included 334 patients. All remission and LDA criteria were significantly associated with the SF-36 physical component summary, with SLE-DAS remission demonstrating superior accuracy metrics compared with DORIS remission. No associations were observed with the mental component summary for any remission or LDA criteria. Regarding the EuroQol-5D, no correlations were identified with DORIS remission; however, correlations were observed with other remissions and LDA criteria. Remission and LDA criteria based on the safety of oestrogens in lupus erythematosus national assessment SLE disease activity index and SLE-DAS exhibited similar associations with PROs. SLE-DAS remission and LDA represent valid treatment targets in a T2T approach, comparable to DORIS remission and LLDAS in terms of PROs.