Rheumatology (Oxford, England) · 2026
Ability of SLE-DAS and SLEDAI-2K to predict damage accrual in SLE: A real-world 7-year cohort study from Sweden.
СтатьяНазвание и аннотация: Перевод в очереди
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Andraos Rama, Tsoi Alexander, Kastbom Alf, Frodlund Martina, Jesus Diogo, Inês Luís Sousa, Parodis Ioannis, Sjöwall Christopher
Аннотация
OBJECTIVES: SLE remains a heterogeneous autoimmune disease that can lead to irreversible organ damage. SLE Disease Activity Score (SLE-DAS) is a recently developed tool with higher sensitivity to change than SLE Disease Activity Index-2000 (SLEDAI-2K). We compared SLE-DAS with other activity measures in terms of ability to predict organ damage.
METHODS: Patients from Linköping University Hospital with ≥2 visits between 2008 and 2025 were included. SLEDAI-2K and Physician's Global Assessment (PhGA) were assessed prospectively, and SLE-DAS retrospectively. Organ damage was estimated annually using the SLICC/ACR Damage Index (SDI). Adjusted mean scores of SLEDAI-2K (amSLEDAI-2K), PhGA (amPhGA), and SLE-DAS (amSLE-DAS) were determined for each time interval between consecutive visits, and their ability to predict damage accrual was evaluated using time-dependent multivariable Cox regression models. Predictive ability was compared across measures using Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC).
RESULTS: In total, 335 patients with 3582 outpatient visits contributed data. amSLE-DAS was an independent predictor of SDI increase at the 3- (HR; 95% CI: 1.04; 1.00-1.08), 5- (1.05; 1.01-1.09), and 7-year follow-up (1.04; 1.00-1.08). amSLEDAI-2K was predictive at the 5-year follow-up only (1.12; 1.02-1.22), and amPhGA at 5 (1.99; 1.19-3.36) and 7 (1.84; 1.02-3.30) years. amSLE-DAS showed a higher predictive ability for damage accrual than amSLEDAI-2K at the 3-, 5-, and 7-year follow-up, as indicated by lower AIC and BIC.
CONCLUSION: In this real-world Swedish setting, we demonstrate that SLE-DAS outperforms SLEDAI-2K in predicting organ damage accrual in SLE, substantiating its clinical relevance.
METHODS: Patients from Linköping University Hospital with ≥2 visits between 2008 and 2025 were included. SLEDAI-2K and Physician's Global Assessment (PhGA) were assessed prospectively, and SLE-DAS retrospectively. Organ damage was estimated annually using the SLICC/ACR Damage Index (SDI). Adjusted mean scores of SLEDAI-2K (amSLEDAI-2K), PhGA (amPhGA), and SLE-DAS (amSLE-DAS) were determined for each time interval between consecutive visits, and their ability to predict damage accrual was evaluated using time-dependent multivariable Cox regression models. Predictive ability was compared across measures using Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC).
RESULTS: In total, 335 patients with 3582 outpatient visits contributed data. amSLE-DAS was an independent predictor of SDI increase at the 3- (HR; 95% CI: 1.04; 1.00-1.08), 5- (1.05; 1.01-1.09), and 7-year follow-up (1.04; 1.00-1.08). amSLEDAI-2K was predictive at the 5-year follow-up only (1.12; 1.02-1.22), and amPhGA at 5 (1.99; 1.19-3.36) and 7 (1.84; 1.02-3.30) years. amSLE-DAS showed a higher predictive ability for damage accrual than amSLEDAI-2K at the 3-, 5-, and 7-year follow-up, as indicated by lower AIC and BIC.
CONCLUSION: In this real-world Swedish setting, we demonstrate that SLE-DAS outperforms SLEDAI-2K in predicting organ damage accrual in SLE, substantiating its clinical relevance.