Background/Purpose: Systemic Lupus Erythematosus Disease Activity Score (SLE-DAS) is a newly developed tool for assessing disease activity in SLE patients. Despite external validation in diverse populations, the clinical utility of SLE-DAS remains underexplored. This study aims to assess the prognostic significance of SLE-DAS by comparing it with the SLE Disease Activity Index (SLEDAI-2K) over a 5-year follow-up period among Korean SLE patients.

Methods: We enrolled 199 SLE patients from the Korean Lupus Network (KORNET) registry. Demographic data, clinical manifestations, laboratory findings, Physician Global Assessment (PGA), SLEDAI-2K, SLICC damage index (SDI), SF-36, and Beck Depression Inventory (BDI) were assessed at enrollment and annually for 5 years. Longitudinal associations between disease activity indices and clinical outcomes were analyzed using generalized estimating equations (GEEs).

Results: During the follow-up period, 27.1% of patients were in remission, 50.3% had mild activity, and 22.6% had moderate/severe activity. Spearman coefficients between SLE-DAS and SLEDAI-2K ranged from 0.889 to 0.907 across the 1st to 5th years. Changes in SLE-DAS were significantly associated with disease flare (ß = 0.435, 95% CI: 0.037 ~ 0.832, P = 0.032) and PGA (ß = 1.399, 95% CI: 0.608 ~ 2.190, P < 0.001), but not with SDI, SF-36, or BDI. On the other hand, changes in SLEDAI were significantly associated with PGA (ß = 0.653, 95% CI: 0.091 ~ 1.215, P = 0.013), but not with flare, SDI, SF-36, or BDI.

Conclusion: Although SLE-DAS exhibits superior predictive performance for disease flare compared to SLEDAI-2K, both indices demonstrate similar prognostic value in SLE patients.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/clinical-relevance-of-the-systemic-lupus-erythematosus-disease-activity-score-sle-das-in-predicting-lupus-outcomes-a-5-year-longitudinal-cohort-study/