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

Ronald van Vollenhoven, George Βertsias(University Hospital of Heraklion), Andrea Doria(University of Padua), David Isenberg(University College London), Eric F. Morand(Monash Medical Centre), Michelle Petri(Johns Hopkins University), Bernardo A. Pons‐Estel(Hospital Provincial de Rosario), Anisur Rahman(University College London), Manuel F. Ugarte‐Gil(Universidad Científica del Sur), Alexandre E. Voskuyl(Amsterdam UMC Location Vrije Universiteit Amsterdam), Laurent Arnaud(Université de Strasbourg), Ian N Bruce(University of Manchester), Ricard Cervera(Hospital Clínic de Barcelona), N. Costedoat‐Chalumeau(Hôpital Cochin), Caroline Gordon(University of Birmingham), Frédéric Houssiau(Cliniques Universitaires Saint-Luc), Marta Mosca(University of Pisa), Matthias Schneider(Heinrich Heine University Düsseldorf), Michael M. Ward(National Institutes of Health), Graciela S. Alarcón(University of Alabama at Birmingham), Martin Aringer, Anca Askanase(Columbia University Irving Medical Center), Sang‐Cheol Bae(Hanyang University Seoul Hospital), Hendrika Bootsma(University Medical Center Groningen), Dimitrios T. Boumpas(National and Kapodistrian University of Athens), Hermine I. Brunner(Cincinnati Children's Hospital Medical Center), Ann E. Clarke(University of Calgary), Cindy Coney(Lupus Foundation of America), László Czirják(University of Pecs), Thomas Dörner(Charité - Universitätsmedizin Berlin), Raquel Faria(CUF Porto Hospital), Rebecca S. B. Fischer(Heinrich Heine University Düsseldorf), Ruth Fritsch‐Stork(Hanusch Hospital), Murat İnanç(Istanbul University), Søren Jacobsen(Copenhagen University Hospital), David Jayne(University of Cambridge), Annegret Kuhn, Bernadette van Leeuw, Maarten Limper(University Medical Center Utrecht), Xavier Mariette(Université Paris-Saclay), Sandra Navarra(University of Santo Tomas Hospital), Mandana Nikpour(The University of Melbourne), Marzena Olesińska(National Institute of Geriatrics, Rheumatology and Rehabilitation), Guillermo Pons‐Estel(Hospital Provincial de Rosario), Juanita Romero‐Díaz(Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán), Blanca Rubio, Y Schoenfeld(Sheba Medical Center), Eloísa Bonfá(Universidade de São Paulo), Josef S Smolen(Medical University of Vienna), Y K Onno Teng(Leiden University), Anǵela Tincani(University of Brescia), Michel Tsang-A-Sjoe(Amsterdam UMC Location Vrije Universiteit Amsterdam), Carlos Vasconcelos, Anne Voss(University of Southern Denmark), Victoria P. Werth(University of Pennsylvania), Elena Zakharhova(Moscow State University of Medicine and Dentistry), Cynthia Aranow(Feinstein Institute for Medical Research)
Lupus Science & Medicine
November 1, 2021
10.1136/lupus-2021-000538
Cited by 334Open Access
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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.

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