2021 DORIS definition of remission in SLE: final recommendations from an international task force.

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.

Informations de copyright

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: RFvV has received research and educational support (grants) from BMS, GSK, Lilly, Pfizer, Roche and UCB; and reimbursement for consultancy and/or speaking from AbbVie, AstraZeneca, Biogen, Biotest, BMS, Galapagos, Gilead, GSK, Janssen, Pfizer, Sanofi, Servier, UCB and Vielabio. RC—GSK, Alexion, Eli Lilly, AstraZeneca, Termo-Fisher and Rubió. BAP-E—GSK and Janssen. MFU-G received research grants from Janssen and Pfizer. LA acted as a consultant for Alexion, Amgen, AstraZeneca, BMS, GSK, Janssen-Cilag, LFB, Lilly, Menarini France, Medac, Novartis, Pfizer, Roche-Chugaï and UCB. CG—personal fees for honoraria from consultancy work from the Center for Disease Control, AstraZeneca, MGP, Sanofi and UCB; and personal fees for speaker’s bureau from UCB. HBo—unrestricted grants from Bristol-Myers Squibb and Roche; consultant for Bristol-Myers Squibb, Roche, Novartis, Medimmune and Union Chimique Belge; speaker for Bristol-Myers Squibb and Novartis; member of the advisory board of Bristol-Myers Squibb, Novartis and Sanofi. MI—consultations from GSK and Amgen. DJ—AstraZeneca, Aurinia, BMS, Boehringer-Ingelheim, Chemocentryx, Chugai, CSL, GSK, Infla-RX, Janssen, Novartis, Roche/Genentech, Takeda and Vifor. AK—honoraria from Bristol-Myers Squibb, KGaA, GlaxoSmithKline, Janssen Cilag and Lilly Deutschland. ML—receipts from GSK for advisory boards and sponsoring of investigator-initiated study. MN—research support from Actelion, AstraZeneca, BMS, GSK, Janssen and UCB; and honoraria from Actelion, Boehringer Ingelheim, Eli Lilly, GSK, Janssen, Pfizer and UCB. AT—consultation/speaker fees from UCB, GSK, Novartis and Janssen.