ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 0770

Evaluation of the Lupus Low Disease Activity State (LLDAS) vs. the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)-2K Score in a Pediatric Systemic Lupus Erythematosus Cohort

Bridget Wilson, Tingting Qiu, Angela Merritt, Bin Huang and Hermine Brunner, Cincinnati Children's Hospital Medical Center, Cincinnati, OH

Meeting: ACR Convergence 2021

Keywords: LLDAS, Pediatric rheumatology, Systemic lupus erythematosus (SLE), Treatment Target

  • Tweet
  • Email
  • Print
Session Information

Date: Sunday, November 7, 2021

Title: Pediatric Rheumatology – Clinical Poster II: SLE, JDM, & Juvenile Scleroderma (0764–0785)

Session Type: Poster Session B

Session Time: 8:30AM-10:30AM

Background/Purpose: Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease which can affect any organ system, and ongoing disease activity leads to organ damage. The Lupus Low Disease Activity State (LLDAS) has been evaluated in adult patients, but not yet in pediatrics. In adults, achieving LLDAS was shown to decrease morbidity and mortality and was associated with improved quality of life. The Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)-2K is a weighted scale measuring presence of SLE activity in nine organ systems. In children with SLE, disease activity measured by the SLEDAI-2K < 4 (low SLEDAI-status) is considered to reflect good disease control currently. The purpose of the study was to compare LLDAS and low SLEDAI-status in children with SLE.

Methods: LLDAS metrics were recorded for 1204 clinic visits from 117 patients (83% female; 41% black) enrolled in the SLE Database at Cincinnati Children’s Hospital Medical Center (see table 1). Visits with incomplete data to score the LLDAS were omitted. LLDAS criteria include: (1) low SLEDAI-status, without activity in major organ systems; (2) no new SLE disease activity compared with previous assessment; (3) physician global assessment (PGA) ≤1 (range 0-10); (4) current prednisolone (or equivalent) dose ≤ 7.5 mg/day; and (5) well tolerated standard maintenance doses of immunosuppressive drugs or approved biological agents, excluding investigational drugs.

Results: The majority (65%, 785/1204) of visits met low SLEDAI-status criteria, of which only 40% (312/785) met the LLDAS criteria (see table 2). Of those visits meeting low SLEDAI-status but not meeting LLDAS (N=473), 51% (N=241) presented new SLE activity from the previous visit; 50% (N=238) had current prednisolone (or equivalent) dose >7.5 mg daily, and 44% (N=209) had PGA >1 (see figure 1).

Conclusion: LLDAS is more stringent than low SLEDAI-status, which is the current treatment target. If confirmed that children with SLE accrue less disease damage with LLDAS versus low SLEDAI-status, this would change treatment targets, hence the standards of clinical care. The study also suggested the need to refine LLDAS for pediatric patients, particularly the criteria for prednisolone dosage.

Table 1: Patient Demographics

Table 2: Clinic Visits Achieving Low SLEDAI_2K Status and LLDAS

Figure 1: Heat Map of Clinic Visits Showing Low SLEDAI_2K Status and Particular LLDAS Criteria Met


Disclosures: B. Wilson, None; T. Qiu, None; A. Merritt, None; B. Huang, None; H. Brunner, Novartis, 6, Pfizer, 6, Roche, 6, GlaxoSmithKline, 6, Abbvie, 12, Contributions to employer (Cincinatti Children's Hospital) *NOTE: This funding has been reinvested for the research activities of the hospital in a fully independent manner without any commitment to third parties, Biogen, 12, Contributions to employer (Cincinatti Children's Hospital) *NOTE: This funding has been reinvested for the research activities of the hospital in a fully independent manner without any commitment to third parties, AstraZeneca-Mediimmune, 12, Contributions to employer (Cincinatti Children's Hospital) *NOTE: This funding has been reinvested for the research activities of the hospital in a fully independent manner without any commitment to third parties, Boehringer, 12, Contributions to employer (Cincinatti Children's Hospital) *NOTE: This funding has been reinvested for the research activities of the hospital in a fully independent manner without any commitment to third parties, BMS, 12, Contributions to employer (Cincinatti Children's Hospital) *NOTE: This funding has been reinvested for the research activities of the hospital in a fully independent manner without any commitment to third parties, Celgene, 12, Contributions to employer (Cincinatti Children's Hospital) *NOTE: This funding has been reinvested for the research activities of the hospital in a fully independent manner without any commitment to third parties, Eli Lilly, 12, Contributions to employer (Cincinatti Children's Hospital) *NOTE: This funding has been reinvested for the research activities of the hospital in a fully independent manner without any commitment to third parties, EMD Serono, 12, Contributions to employer (Cincinatti Children's Hospital) *NOTE: This funding has been reinvested for the research activities of the hospital in a fully independent manner without any commitment to third parties, Idorsia, 12, Contributions to employer (Cincinatti Children's Hospital) *NOTE: This funding has been reinvested for the research activities of the hospital in a fully independent manner without any commitment to third parties, Cerocor, 12, Contributions to employer (Cincinatti Children's Hospital) *NOTE: This funding has been reinvested for the research activities of the hospital in a fully independent manner without any commitment to third parties, F.Hoffman-La Roche, 12, Contributions to employer (Cincinatti Children's Hospital) *NOTE: This funding has been reinvested for the research activities of the hospital in a fully independent manner without any commitment to third parties, Merck, 12, Contributions to employer (Cincinatti Children's Hospital) *NOTE: This funding has been reinvested for the research activities of the hospital in a fully independent manner without any commitment to third parties, Novartis, 12, Contributions to employer (Cincinatti Children's Hospital) *NOTE: This funding has been reinvested for the research activities of the hospital in a fully independent manner without any commitment to third parties, Sanofi, 12, Contributions to employer (Cincinatti Children's Hospital) *NOTE: This funding has been reinvested for the research activities of the hospital in a fully independent manner without any commitment to third parties, Aurina, 2.

To cite this abstract in AMA style:

Wilson B, Qiu T, Merritt A, Huang B, Brunner H. Evaluation of the Lupus Low Disease Activity State (LLDAS) vs. the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)-2K Score in a Pediatric Systemic Lupus Erythematosus Cohort [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 9). https://acrabstracts.org/abstract/evaluation-of-the-lupus-low-disease-activity-state-lldas-vs-the-systemic-lupus-erythematosus-disease-activity-index-sledai-2k-score-in-a-pediatric-systemic-lupus-erythematosus-cohort/. Accessed .
  • Tweet
  • Email
  • Print

« Back to ACR Convergence 2021

ACR Meeting Abstracts - https://acrabstracts.org/abstract/evaluation-of-the-lupus-low-disease-activity-state-lldas-vs-the-systemic-lupus-erythematosus-disease-activity-index-sledai-2k-score-in-a-pediatric-systemic-lupus-erythematosus-cohort/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology