The BILAG-2004 index is sensitive to change for assessment of SLE disease activity

Chee Seng Yee, Vernon Farewell, David A. Isenberg, Bridget Griffiths, Lee Suan Teh, Ian N. Bruce, Yasmeen Ahmad, Anisur Rahman, Athiveeraramapandian Prabu, Mohammed Akil, Neil McHugh, Christopher Edwards, David D'Cruz, Munther A. Khamashta, Peter Maddison, Caroline Gordon

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Objective. To determine if the BILAG-2004 index is sensitive to change for assessment of SLE disease activity. Methods. This was a prospectivemulti-centre longitudinal study of SLE patients. At every assessment, data were collected on disease activity (BILAG-2004 index) and treatment. Analyses were performed using overall BILAG-2004 index score (as determined by the highest score achieved by any of the individual systems) and all the systems scores. Sensitivity to change was assessed by determining the relationship between change in disease activity and change in therapy between two consecutive visits. Statistical analyses were performed using multinomial logistic regression. Results. There were 1761 assessments from 347 SLE patients that contributed 1414 observations for analysis. An increase in therapy between visits occurred in 22.7% observations, while 37.3% had a decrease in therapy and in 40.0% therapy was unchanged. Increase in overall BILAG-2004 index score was associated with increase in therapy and inversely associated with decrease in therapy. Decrease in overall BILAG-2004 index score was associated with decrease in therapy and was inversely associated with increase in therapy. Changes in overall BILAG-2004 index score were differentially related to change in therapy, with greater change in score having greater predictive power. Increase in the scores of most systems was independently associated with an increase in treatment and there was no significant association between decreases in the score of any system with an increase in therapy. Conclusions. The BILAG-2004 index is sensitive to change and is suitable for use in longitudinal studies of SLE. © 2009 The Author(s).
    Original languageEnglish
    Pages (from-to)691-695
    Number of pages4
    JournalRheumatology
    Volume48
    Issue number6
    DOIs
    Publication statusPublished - 2009

    Keywords

    • BILAG-2004
    • Disease activity
    • Epidemiology
    • Outcome measures
    • Responsiveness
    • Sensitivity to change
    • SLE
    • Statistics

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