Ramos-Lisbona Ana Isabel, Allameen Nur Azizah, Isenberg David A
Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Rheumatology Service, Department of Medicine, Woodlands Health, Singapore.
Rheumatol Adv Pract. 2025 May 26;9(3):rkaf062. doi: 10.1093/rap/rkaf062. eCollection 2025.
Capturing disease activity in SLE remains challenging. The binary nature of global score indices such as the SLEDAI 2000 (SLEDAI-2K) poses limitations, while the complexity of the BILAG-2004 index requires training and more time investment. Recent efforts to improve SLE activity indices include the SLE Disease Activity Score (SLE-DAS) and Easy-BILAG system. This review analyses the main indices used to assess SLE activity, examines their progressive refinements, evaluates their advantages and limitations and aims to identify the optimal index. The SLE-DAS offers greater sensitivity than the SLEDAI-2K and the Easy-BILAG simplifies scoring while maintaining the comprehensiveness of the BILAG-2004. Composite indices like the SLE Responder Index and BILAG-based Composite Lupus Assessment integrate the SLEDAI-2K and BILAG-2004 but are mainly used in clinical trials due to their complexity. This review emphasizes the importance of balancing sensitivity, specificity, simplicity and comprehensiveness in lupus activity measurement. The search for the optimal index remains ongoing.
在系统性红斑狼疮（SLE）中捕捉疾病活动情况仍然具有挑战性。全球评分指数（如2000年系统性红斑狼疮疾病活动指数（SLEDAI - 2K））的二元性质存在局限性，而BILAG - 2004指数的复杂性需要培训且投入更多时间。近期改善SLE活动指数的努力包括SLE疾病活动评分（SLE - DAS）和简易BILAG系统。本综述分析了用于评估SLE活动的主要指数，研究了它们的逐步改进，评估了其优缺点，并旨在确定最佳指数。SLE - DAS比SLEDAI - 2K具有更高的敏感性，简易BILAG简化了评分，同时保持了BILAG - 2004的全面性。像SLE反应指数和基于BILAG的综合狼疮评估等综合指数整合了SLEDAI - 2K和BILAG - 2004，但由于其复杂性主要用于临床试验。本综述强调在狼疮活动测量中平衡敏感性、特异性、简易性和全面性的重要性。寻找最佳指数的工作仍在继续。
