Validity of the Systemic Lupus Erythematosus Disease Activity 2000-Glucocorticoid Index, its association with the Physician Global Assessment, and potential association with disease damage

Validity of the Systemic Lupus Erythematosus Disease Activity 2000-Glucocorticoid Index, its association with the Physician Global Assessment, and potential association with disease damage

Abstract Background The Systemic Lupus Erythematosus Disease Activity-2000 Glucocorticoid Index (SLEDAI-2 KG) accounts for glucocorticoids and possibly promising. The Physician Global Assessment (PGA) is subjective and debatable. Objectives Assessment of the validity of the SLEDAI-2 KG, its associat...

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Main Authors: Basma M. Medhat, Lobna A. Maged, Doaa A. Teleb, Sally S. Mohamed, Angie Y. Afifi, Dina M. T. Koptan, Walaa Abdelrahman, Dalia Dorgham, Eman Hany Elsebaie, Naglaa Afifi, Sahar A. Ahmed, Mervat E. Behairy, Hala Ramadan
Format: Article
Language:English
Published: SpringerOpen 2025-01-01
Series:The Egyptian Journal of Internal Medicine
Subjects:
Systemic lupus erythematosus
SLEDAI-2 K
Glucocorticoid
Physician Global Assessment
Disease Activity
Disease Damage
Online Access:https://doi.org/10.1186/s43162-024-00389-3
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Summary:Abstract Background The Systemic Lupus Erythematosus Disease Activity-2000 Glucocorticoid Index (SLEDAI-2 KG) accounts for glucocorticoids and possibly promising. The Physician Global Assessment (PGA) is subjective and debatable. Objectives Assessment of the validity of the SLEDAI-2 KG, its association with the PGA, and their potential association with the disease damage. Methods A cross-sectional study included SLE patients managed at 2 tertiary centers in Egypt were conducted. The SLEDAI-2 K was the gold standard score for assessment the disease activity. The SLEDAI-2 KG incorporates glucocorticoids’ dosage through an ordinal weight. The PGA (scale: 0–3) was categorized according to the PGA international standardization consensus in SLE study (PISCOS). Results The study included 608 patients [546 (89.8%) females and [62 (10.2%) males; age at onset: 27.5 ± 8.5 years; age at assessment: 31.4 ± 9.4 years; disease duration: 6.1 ± 5.5 years for females]. The mean SLEDAI-2 K, SLEDAI-2 KG, and PGA was 11.9 ± 9.3, 16 ± 10.5, and 1.2 ± 0.8, respectively. The correlation between both the SLEDAI-2 KG (r: 0.96, p < 0.001) and PGA (r: 0.5, p < 0.001) and SLEDAI-2 K was statistically significant. The association’s strength between both the SLEDAI-2 KG and PGA and SLEDAI-2 K declined among low activity-patients (SLEDAI-2 K < 6) [(r = 0,4; p < 0.001) (r = 0.2; p = 0.02), respectively], and the SLEDAI-2 KG and PGA were not associated in this subgroup (r: 0.07, p = 0.4). The agreement’s strength between the SLEDAI-2 K and PISCOS-PGA was weak (kappa = 0.17, p < 0.001). The SLEDAI-2 K and SLEDAI-2 KG were comparable predictors for damage and the PGA was a weaker predictor. Conclusion The SLEDAI-2 KG and PGA correlated significantly with the SLEDAI-2 K, yet the correlation’s strength declined among low disease activity-patients. The SLEDAI-2 K and SLEDAI-2 KG were comparable predictors for damage.
ISSN:2090-9098

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