Lupus Science and Medicine (Apr 2021)
2021 DORIS definition of remission in SLE: final recommendations from an international task force
- Victoria P Werth,
- Ronald F van Vollenhoven,
- Andrea Doria,
- Matthias Schneider,
- Marta Mosca,
- Nathalie Costedoat-Chalumeau,
- Cynthia Aranow,
- Ian N Bruce,
- Dimitrios T Boumpas,
- Michael M Ward,
- Manuel Francisco Ugarte-Gil,
- Bernardo A Pons-Estel,
- Juanita Romero-Diaz,
- Caroline Gordon,
- Sang-Cheol Bae,
- Anisur Rahman,
- Murat Inanc,
- Søren Jacobsen,
- George Bertsias,
- Xavier Mariette,
- Thomas Dörner,
- Hendrika Bootsma,
- Josef Smolen,
- David Jayne,
- Martin Aringer,
- David Isenberg,
- László Czirják,
- Y K Onno Teng,
- Frédéric A Houssiau,
- Hermine Brunner,
- Eric Morand,
- Carlos Vasconcelos,
- Guillermo Pons-Estel,
- Graciela Alarcon,
- Eloisa Bonfa,
- Alexandre Voskuyl,
- Raquel Faria,
- Anne Voss,
- Maarten Limper,
- Anca D Askanase,
- Sandra Navarra,
- Cindy Coney,
- Ruth Fritsch-Stork,
- Bernadette van Leeuw,
- Michel Tsang-a-Sjoe,
- Rebecca Fischer,
- Marzena Helena Olesinska,
- Blanca Rubio,
- Yehuda Schoenfeld,
- Elena Zakharhova
Affiliations
- Victoria P Werth
- Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Ronald F van Vollenhoven
- Department of Rheumatology and Clinical Immunology, Amsterdam University Medical Center, Amsterdam, The Netherlands
- Andrea Doria
- Division of Rheumatology, University of Padova, Padova, Italy
- Matthias Schneider
- Department of Rheumatology & Hiller Research Unit Rheumatology, UKD, Heinrich-Heine University, Duesseldorf, Germany
- Marta Mosca
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- Nathalie Costedoat-Chalumeau
- Medecine Interne Cochin Hospital, Paris, France
- Cynthia Aranow
- Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York, USA
- Ian N Bruce
- Kellgren Centre for Rheumatology, Manchester University Hospitals NHS Trust, Manchester, UK
- Dimitrios T Boumpas
- Laboratory of Autoimmunity and Inflammation, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy, Athens, Greece
- Michael M Ward
- 3 Intramural Research Program, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland, USA
- Manuel Francisco Ugarte-Gil
- Grupo Peruano de Estudio de Enfermedades Autoinmunes Sistémicas, Universidad Cientifica del Sur, Lima, Peru
- Bernardo A Pons-Estel
- 5Rheumatology, Grupo Oroño – Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Rosario, Argentina
- Juanita Romero-Diaz
- Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Mexico
- Caroline Gordon
- Rheumatology Research Group, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- Sang-Cheol Bae
- 28 Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea (the Republic of)
- Anisur Rahman
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Dhaka District, Bangladesh
- Murat Inanc
- Internal Medicine Rheumatology, University of Istanbul, Istanbul, Turkey
- Søren Jacobsen
- Department of Rheumatology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- George Bertsias
- Rheumatology, Clinical Immunology and Allergy Department, University of Crete School of Medicine, Heraklion, Greece
- Xavier Mariette
- 32 Department of Rheumatology, Université Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, INSERM UMR1184, Le Kremlin Bicêtre, France
- Thomas Dörner
- Department of Rheumatology and Clinical Immunology, Charité – Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Hendrika Bootsma
- 1 Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Josef Smolen
- Medical University of Vienna, Wien, Austria
- David Jayne
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
- Martin Aringer
- Division of Rheumatology, Department of Medicine III, University Medical Center and Faculty of Medicine at the TU Dresden, Dresden, Germany
- David Isenberg
- Centre for Rheumatology, Department of Medicine, University College London, London, UK
- László Czirják
- Department of Rheumatology and Immunology, Medical School, University of Pécs, Pécs, Hungary
- Y K Onno Teng
- Centre of expertise for Lupus-, Vasculitis- and Complement-mediated Systemic autoimmune diseases, Department of Internal Medicine – section Nephrology, Leiden University Medical Center, Leiden, The Netherlands
- Frédéric A Houssiau
- Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
- Hermine Brunner
- 8Cincinnati Children’s Hospital Medical Center, Cincinnati, United States of America
- Eric Morand
- 1Department of Medicine, School of Clinical Sciences at MH, Monash University, Australia, Australia
- Carlos Vasconcelos
- University of Porto, UMIB, Abel Salazar Biomedical Sciences Institute, Porto, Portugal
- Guillermo Pons-Estel
- 51 Department of Rheumatology, Grupo Oroño-Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Rosario, Argentina
- Graciela Alarcon
- University of Alabama, Birmingham, Alabama, USA
- Eloisa Bonfa
- Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, Rheumatology Division, Sao Paulo, Brazil
- Alexandre Voskuyl
- VUmc, Rheumatology, Amsterdam, Netherlands
- Raquel Faria
- Clinical Immunology Unit, Porto Hospital and University Center, Porto, Portugal
- Anne Voss
- 2Odernse University Hospital, Rheumatology, Odense, Denmark
- Maarten Limper
- 14University Medical Center Utrecht, Utrecht, Netherlands
- Anca D Askanase
- Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
- Sandra Navarra
- 14 University of Santo Tomas Hospital, Manila, The Philippines
- Cindy Coney
- Lupus Foundation of America, Washington, District of Columbia, USA
- Ruth Fritsch-Stork
- First Medical Department, Hanusch Hospital, Wien, Austria
- Bernadette van Leeuw
- Lupus Europe, Brussels, Belgium
- Michel Tsang-a-Sjoe
- Rheumatology, VU University Medical Centre Amsterdam, Amsterdam, The Netherlands
- Rebecca Fischer
- Rheumatology, Heinrich-Heine-University, Duesseldorf, Germany
- Marzena Helena Olesinska
- Institute of Rheumatology, Warsaw, Poland
- Blanca Rubio
- Lupus Europe, Brussels, Belgium
- Yehuda Schoenfeld
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Tel Aviv, Israel
- Elena Zakharhova
- Rheumatology, A I Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of the Russian Federation Faculty of Dentistry, Moskva, Russian Federation
- DOI
- https://doi.org/10.1136/lupus-2021-000538
- Journal volume & issue
-
Vol. 8,
no. 1
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.
