2021 DORIS definition of remission in SLE: final recommendations from an international task force
Ronald van Vollenhoven, George Βertsias, Andrea Doria, David Isenberg, Eric F. Morand, Michelle Petri, Bernardo A. Pons‐Estel, Anisur Rahman, Manuel F. Ugarte‐Gil, Alexandre E. Voskuyl, Laurent Arnaud, Ian N Bruce, Ricard Cervera, N. Costedoat‐Chalumeau, Caroline Gordon, Frédéric Houssiau, Marta Mosca, Matthias Schneider, Michael M. Ward, Graciela S. Alarcón, Martin Aringer, Anca Askanase, Sang‐Cheol Bae, Hendrika Bootsma, Dimitrios T. Boumpas, Hermine I. Brunner, Ann E. Clarke, Cindy Coney, László Czirják, Thomas Dörner, Raquel Faria, Rebecca S. B. Fischer, Ruth Fritsch‐Stork, Murat İnanç, Søren Jacobsen, David Jayne, Annegret Kuhn, Bernadette van Leeuw, Maarten Limper, Xavier Mariette, Sandra Navarra, Mandana Nikpour, Marzena Olesińska, Guillermo Pons‐Estel, Juanita Romero‐Díaz, Blanca Rubio, Y Schoenfeld, Eloísa Bonfá, Josef S Smolen, Y K Onno Teng, Anǵela Tincani, Michel Tsang-A-Sjoe, Carlos Vasconcelos, Anne Voss, Victoria P. Werth, Elena Zakharhova, Cynthia Aranow
Abstract
OBJECTIVE: To achieve consensus on a definition of remission in SLE (DORIS). BACKGROUND: Remission is the stated goal for both patient and caregiver, but consensus on a definition of remission has been lacking. Previously, an international task force consisting of patient representatives and medical specialists published a framework for such a definition, without reaching a final recommendation. METHODS: Several systematic literature reviews were performed and specific research questions examined in suitably chosen data sets. The findings were discussed, reformulated as recommendations and voted on. RESULTS: Based on data from the literature and several SLE-specific data sets, a set of recommendations was endorsed. Ultimately, the DORIS Task Force recommended a single definition of remission in SLE, based on clinical systemic lupus erythematosus disease activitiy index (SLEDAI)=0, Evaluator's Global Assessment <0.5 (0-3), prednisolone 5 mg/day or less, and stable antimalarials, immunosuppressives, and biologics. CONCLUSION: The 2021 DORIS definition of remission in SLE is recommended for use in clinical care, education, and research including clinical trials and observational studies.