Therapeutic adherence in patients with systemic lupus erythematosus: a cross-sectional study

Abstract

Introduction. The aim of the research was the study of the adherence to treatment in patients

Use of Physician Global Assessment (PGA) in Systemic lupus erythematosus: a systematic review of its psychometric properties

“…Supporting the face validity property, PGA was defined “gold-standard” in 11 studies (2, 10-11, 21, 32, 49, 67, 76, 78, 84, 88) and in 32 it was used as the reference to which other activity scores were compared, such as the SLEDAI (4, 10, 13, 25, 27-28, 31, 33, 35-36, 41, 46-47, 50-51, 53, 62, 65, 68, 72-73, 76, 81, 96-99), BILAG (4, 27, 35-36, 46, 65, 72-73, 81, 98), SLAM (4, 72, 76, 99), LAI (68, 88), patient global assessment (ptGA) (81, 83-84) and ECLAM (35). However, it was used as a single outcome measure only in two studies (49, 100) whilst in the majority the PGA was scored together with another instrument (typically the SLEDAI) (2, 9, 11-12, 21, 24, 30, 32, 34, 37-40, 44-45, 48-49, 55, 58-59, 61, 63-64, 66-67, 74-75, 80, 82, 86, 89-95, 103).…”

“…In one open-label study (43) the decrease in PGA score was considered the primary endpoint. In 32 studies, disease activity measured by PGA was compared to changes in laboratory markers, with the aim to correlate clinical and serological features (9, 21, 30, 32, 34, 37-39, 44-45, 48-49, 55, 58-61, 63-64, 66-67, 69, 71, 74-75, 82, 86, 89, 91-94).…”

“…The PGA was integrated in composite indices, including the definition of LLDAS (12-13, 29, 34, 37, 39-40) and remission (29, 37) (table1). In 11 retrieved studies (10, 13, 33, 36, 45, 48, 50, 55-56, 65, 96) the PGA was part of SELENA Flare Index (SFI) (104) and in 10 studies (3, 29, 40, 46, 52, 60, 69, 80, 94, 98) it was part of the Systemic Responder Index (SRI) (3) (both discussed in responsiveness paragraph).…”

“…Twenty-nine studies (25, 31, 34-39, 41, 43, 48-49, 53-55, 59, 61-64, 74-75, 81, 82, 86, 92-93, 96-97) have assessed criterion validity of PGA (table 2).…”

“…Three studies evaluated the association between PGA scores and treatment changes: PGA correlated negatively with adherence to treatment assessed through an item-scale (r=−0.31, p=0.11) (34); clinically defined mild and moderate flares had a higher disease activity by PGA (P<0.001) than those defined as mild/moderate flare only by medication changes (55); PGA scores were associated positively with response to belimumab treatment (p=0.039) (43).…”