Lupus Clinic, Reumatologia, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di, Roma, Rome, Italy.
PLoS One. 2013 Sep 9;8(9):e73517. doi: 10.1371/journal.pone.0073517. eCollection 2013.
The aim of this study was to evaluate the discriminant capability of the patient acceptable symptom state (PASS) according to disease activity, in a cohort of Italian patients affected by systemic Lupus erythematosus (SLE).
Consecutive SLE patients were enrolled. At each visit, the patients underwent a complete physical examination and the clinical/laboratory data were collected in a standardized, computerized, and electronically-filled form. The evaluation of serum complement C3 and C4 levels and determination of autoantibodies was obtained. Disease activity was assessed with the SLEDAI-2K and ECLAM, while chronic damage was measured with the SLICC. Finally, PASS was assessed in all patients by asking to answer yes or no to a single question.
One hundred sixty-five patients were enrolled (M/F 12/153; mean age 40.4±11.8 years, mean disease duration 109.1±96.2 months). No patients refused to answer, suggesting the acceptability of PASS. A total of 80% of patients rated their state as acceptable. The patients with an acceptable status had significantly lower mean SLEDAI-2K and ECLAM scores than the others [1.8±2.7 versus 3.4±2.3(P=0.004); 0.7±0.9 versus 1.4±1.1(P=0.0027)]. No significant differences were observed when considering chronic damage, evaluated with SLICC.
In the clinical practice, SLE patients assessment performed by using complex disease activity indices such as SLEDAI-2K and ECLAM, could be time consuming. In our study, for the first time, we used PASS, a quick and easily comprehensible tool, to evaluate the patients' status, this single question seems to be able to discriminate patients with different disease activity, especially when this is determined by musculoskeletal involvement.
本研究旨在评估患者可接受症状状态（PASS）根据疾病活动度在意大利系统性红斑狼疮（SLE）患者中的鉴别能力。
连续纳入 SLE 患者。在每次就诊时，患者接受全面的体格检查，并在标准化、计算机化和电子填写的表格中收集临床/实验室数据。评估血清补体 C3 和 C4 水平并确定自身抗体。使用 SLEDAI-2K 和 ECLAM 评估疾病活动度，使用 SLICC 测量慢性损伤。最后，通过询问患者是否接受来评估所有患者的 PASS。
共纳入 165 例患者（M/F 12/153；平均年龄 40.4±11.8 岁，平均病程 109.1±96.2 个月）。没有患者拒绝回答，表明 PASS 可接受。共有 80%的患者认为自己的状态可以接受。状态可接受的患者的平均 SLEDAI-2K 和 ECLAM 评分明显低于其他患者[1.8±2.7 比 3.4±2.3（P=0.004）；0.7±0.9 比 1.4±1.1（P=0.0027）]。当考虑使用 SLICC 评估的慢性损伤时，没有观察到显著差异。
在临床实践中，使用 SLEDAI-2K 和 ECLAM 等复杂疾病活动指数评估 SLE 患者可能会很耗时。在我们的研究中，我们首次使用 PASS，一种快速且易于理解的工具来评估患者的状态，这个简单的问题似乎能够区分不同疾病活动度的患者，尤其是当这种疾病活动度由肌肉骨骼受累决定时。
