International consensus for a definition of disease flare in lupus

Abstract

The Lupus Foundation of America (LFA) convened an international working group to obtain a consensus definition of disease flare in lupus. With help from the Paediatric Rheumatology International Trials Organization (PRINTO), two web-based Delphi surveys of physicians were conducted. Subsequently, the LFA held a second consensus conference followed by a third Delphi survey to reach a community-wide agreement for flare definition. Sixty-nine of the 120 (57.5%) polled physicians responded to the first survey. Fifty-nine of the responses were available to draft 12 preliminary statements, which were circulated in the second survey. Eighty-seven of 118 (74%) physicians completed the second survey, with an agreement of 70% for 9/12 (75%) statements. During the second conference, three alternative flare definitions were consolidated and sent back to the international community. One hundred and sixteen of 146 (79.5%) responded, with agreement by 71/116 (61%) for the following definition: "A flare is a measurable increase in disease activity in one or more organ systems involving new or worse clinical signs and symptoms and/or laboratory measurements. It must be considered clinically significant by the assessor and usually there would be at least consideration of a change or an increase in treatment." The LFA proposes this definition for lupus flare on the basis of its high face validity.

Definition, Categorization, and Terminology of Episodic Breathlessness: Consensus by an International Delphi Survey

“…Definition of consensus was set a priori by a degree of agreement of $70%. 12e14, 21 Similarly, if less than 30% of participants agreed on a defining aspect or term assessed, it was excluded. An assessment was considered for analysis if at least 50% of respondents in each round participated.…”

Healthcare utilization and cost of systemic lupus erythematosus in a US managed care health plan

“…SLE causes significant morbidity and mortality through effects on multiple organ systems including mucocutaneous, musculoskeletal, renal, hematologic, neurologic, and cardiovascular systems 17,18 . Flares associated with SLE are increases in disease activity over a defined period in one or more organ systems involving new or worse clinical signs and symptoms and/or laboratory measurements 19,20 . Over time, flares contribute to progressive, irreversible organ damage, which is present in approximately half of patients within an average of 10 years after diagnosis of SLE [21][22][23][24] .…”

Neutrophil to Lymphocyte Ratio and Mean Platelet Volume as Inflammatory Indicators in Systemic Lupus Erythematosus Nephritis

“…1 SLE goes on with organ involvements by remission and relapses. 2 Lupus nephritis (LN) is an immune complex glomerulonephritis which develops as a complication of SLE.…”