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A framework for rem...
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van Vollenhoven, RKarolinska Institutet
(author)
A framework for remission in SLE: consensus findings from a large international task force on definitions of remission in SLE (DORIS)
- Article/chapterEnglish2017
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LIBRIS-ID:oai:prod.swepub.kib.ki.se:135295823
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http://kipublications.ki.se/Default.aspx?queryparsed=id:135295823URI
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https://doi.org/10.1136/annrheumdis-2016-209519DOI
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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Treat-to-target recommendations have identified ‘remission’ as a target in systemic lupus erythematosus (SLE), but recognise that there is no universally accepted definition for this. Therefore, we initiated a process to achieve consensus on potential definitions for remission in SLE.MethodsAn international task force of 60 specialists and patient representatives participated in preparatory exercises, a face-to-face meeting and follow-up electronic voting. The level for agreement was set at 90%.ResultsThe task force agreed on eight key statements regarding remission in SLE and three principles to guide the further development of remission definitions:1. Definitions of remission will be worded as follows: remission in SLE is a durable state characterised by …………………. (reference to symptoms, signs, routine labs).2. For defining remission, a validated index must be used, for example, clinical systemic lupus erythematosus disease activity index (SLEDAI)=0, British Isles lupus assessment group (BILAG) 2004 D/E only, clinical European consensus lupus outcome measure (ECLAM)=0; with routine laboratory assessments included, and supplemented with physician's global assessment.3. Distinction is made between remission off and on therapy: remission off therapy requires the patient to be on no other treatment for SLE than maintenance antimalarials; and remission on therapy allows patients to be on stable maintenance antimalarials, low-dose corticosteroids (prednisone ≤5 mg/day), maintenance immunosuppressives and/or maintenance biologics.The task force also agreed that the most appropriate outcomes (dependent variables) for testing the prognostic value (construct validity) of potential remission definitions are: death, damage, flares and measures of health-related quality of life.ConclusionsThe work of this international task force provides a framework for testing different definitions of remission against long-term outcomes.
Added entries (persons, corporate bodies, meetings, titles ...)
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Voskuyl, A
(author)
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Bertsias, G
(author)
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Aranow, C
(author)
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Aringer, M
(author)
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Arnaud, L
(author)
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Askanase, A
(author)
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Balazova, P
(author)
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Bonfa, E
(author)
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Bootsma, H
(author)
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Boumpas, D
(author)
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Bruce, I
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Cervera, R
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Clarke, A
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Coney, C
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Costedoat-Chalumeau, N
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Czirjak, L
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Derksen, R
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Doria, A
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Dorner, T
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Fischer-Betz, R
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Fritsch-Stork, R
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Gordon, C
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Graninger, W
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Gyori, N
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Houssiau, F
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Isenberg, D
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Jacobsen, S
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Jayne, D
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Kuhn, A
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Le Guern, V
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Lerstrom, K
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Levy, R
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Machado-Ribeiro, F
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Mariette, X
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Missaykeh, J
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Morand, E
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Mosca, M
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Inanc, M
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Navarra, S
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Neumann, I
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Olesinska, M
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Petri, M
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Rahman, A
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Rekvig, OP
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Rovensky, J
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Shoenfeld, Y
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Smolen, J
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Tincani, A
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Urowitz, M
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van Leeuw, B
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Vasconcelos, C
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Voss, A
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Werth, VP
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Zakharova, H
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Zoma, A
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Schneider, M
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Ward, M
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Karolinska Institutet
(creator_code:org_t)
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Bertsias, G
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Askanase, A
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van Leeuw, B
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