{
  "abstract": "Objectives Systemic lupus erythematosus (SLE) disease activity leads to irreversible organ damage, if not managed adequately. Compared to SLE Disease Activity Index 2000 (SLEDAI-2K) the recently developed SLE Disease Activity Score (SLE-DAS) has shown higher sensitivity to change (Jesus, Ann Rheum Dis. 2019;78(3):365-371). We aimed to determine the ability of SLE-DAS and SLEDAI-2K to predict organ damage accrual assessed with the SLICC/ACR Damage Index (SDI) in a Swedish real-world SLE cohort.Methods Patients fulfilling the 2012 SLICC classification criteria for SLE followed at a Swedish referral centre (Clinical Lupus Register in North-eastern Gothia - KLURING) with at least 2 outpatient visits from 2008 to 2025 were included. SLEDAI-2K and clinical (c)SLEDAI-2K were scored prospectively at each visit, and the SDI was assessed annually. SLE-DAS was scored retrospectively for each visit. The adjusted mean score of SLEDAI-2K (amSLEDAI), cSLEDAI-2K (amcSLEDAI), and SLE-DAS (amSLE-DAS) were determined for each patient and each time interval between consecutive visits. The ability of amSLEDAI, amcSLEDAI, and amSLE-DAS to predict damage accrual (SDI increase from baseline) was evaluated in a time-dependent manner, applying multivariable Cox regression models, along with age and sex as covariates fixed at baseline and prednisone-equivalent dose as a time-dependent variable. Models were applied for 3, 5, and 7 years of follow-up. The predictive value of amSLE-DAS, amcSLEDAI, and amSLEDAI were compared using Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC).Results In total, 335 patients contributed to the analysis (86% women, 23% with history of or current lupus nephritis, 66% with SDI>0 at baseline), totalling 3582 visits. Results are detailed in table 1; amSLE-DAS was an independent predictor of SDI increase at the 3-, 5-, and 7-year follow-up while amSLEDAI was predictive at the 5-year follow-up only. amSLE-DAS showed a higher predictive value for organ damage accrual than amSLEDAI and amcSLEDAI at 3, 5, and 7 years of follow-up, indicated by lower values of AIC and BIC.Abstract S7:05 Table 1Multivariate cox regression analysis for damage accrualConclusions Data from KLURING illustrate that assessment of SLE-DAS is clinically meaningful and yields higher performance in predicting damage accrual compared with SLEDAI-2K and cSLEDAI-2K. Larger studies are warranted to further evaluate SLE-DAS as a disease activity measure.",
  "authors": [
    {
      "affiliations": [
        "Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection/Rheumatology, Linköping, Sweden"
      ],
      "name": "Rama Andraos"
    },
    {
      "affiliations": [
        "Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, and Ce, Stockholm, Sweden"
      ],
      "name": "Alexander Tsoi"
    },
    {
      "affiliations": [
        "Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection/Rheumatology, Linköping, Sweden"
      ],
      "name": "Martina Frodlund"
    },
    {
      "affiliations": [
        "Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection/Rheumatology, Linköping, Sweden"
      ],
      "name": "Alf Kastbom"
    },
    {
      "affiliations": [
        "Rheumatology Department. ULS da Regiao de Leiria, Leiria, Portugal",
        "Faculty of Health Sciences, University of Beira Interior, Covilha, Portugal"
      ],
      "name": "Diogo Jesus"
    },
    {
      "affiliations": [
        "CHUC Lupus Clinic, Rheumatology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal"
      ],
      "name": "Luís Inês"
    },
    {
      "affiliations": [
        "Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, and Ce, Stockholm, Sweden",
        "Department of Rheumatology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden"
      ],
      "name": "Ioannis Parodis"
    },
    {
      "affiliations": [
        "Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection/Rheumatology, Linköping, Sweden"
      ],
      "name": "Christopher Sjöwall"
    }
  ],
  "title": "S7:05 Ability of SLE-DAS and SLEDAI-2K to predict organ damage accrual in SLE: a real-world 7-year cohort study from Sweden",
  "uid": "aff030c4-8583-5424-ae54-bc2127b16367"
}