{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T12:30:35Z","timestamp":1778243435934,"version":"3.51.4"},"reference-count":43,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2021,12,3]],"date-time":"2021-12-03T00:00:00Z","timestamp":1638489600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To derive and validate a definition of low disease activity (LDA) for SLE based on the SLE Disease Activity Score (SLE-DAS), in a real-life multicentre cohort of SLE patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Derivation was conducted using data from a monocentric cohort of SLE (Portugal), and validation was performed in a multicentre cohort (Italy, France and Spain). The Lupus Low Disease Activity State (LLDAS) was used as comparator. We applied receiver operating characteristics curve analysis against the LLDAS to determine the cut-off of SLE-DAS for LDA using bootstrap methodology. In a second step, we tested a definition of SLE-DAS LDA that included: (i) the statistically derived SLE-DAS upper threshold for LDA and (ii) prednisone dose \u22647.5\u2009mg\/day. In the multicentre validation cohort, we assessed the classification performance of this SLE-DAS LDA definition.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We included 774 patients, 300 in the derivation and 474 in the validation cohort. In the derivation cohort, the optimal cut-off to identify patients in LLDAS was SLE-DAS \u22642.48, presenting an area under the curve of 0.965 (95% CI 0.935, 0.994). When applied to the multicentre validation cohort, the SLE-DAS LDA definition showed a sensitivity of 97.1% and a specificity of 97.7% for LLDAS and an almost perfect agreement (Cohen\u2019s Kappa\u2009=\u20090.933; P\u2009&amp;lt;\u20090.001). McNemar\u2019s test found no significant differences between the two definitions (P\u2009=\u20090.092).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The SLE-DAS LDA is a validated, accurate and easy-to-use definition for classifying SLE patients in LDA state.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/rheumatology\/keab895","type":"journal-article","created":{"date-parts":[[2021,11,26]],"date-time":"2021-11-26T20:11:20Z","timestamp":1637957480000},"page":"3309-3316","source":"Crossref","is-referenced-by-count":23,"title":["Definition of low disease activity state based on the SLE-DAS: derivation and validation in a multicentre real-life cohort"],"prefix":"10.1093","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8849-3828","authenticated-orcid":false,"given":"Helena","family":"Assun\u00e7\u00e3o","sequence":"first","affiliation":[{"name":"Rheumatology Department, Centro Hospitalar e Universit\u00e1rio de Coimbra , Coimbra"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3136-0722","authenticated-orcid":false,"given":"Diogo","family":"Jesus","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Centro Hospitalar de Leiria , Leiria"},{"name":"Faculty of Health Sciences, University of Beira Interior , Covilh\u00e3, Portugal"}]},{"given":"Maddalena","family":"Larosa","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, University of Padova , Padova, Italy"}]},{"given":"Carla","family":"Henriques","sequence":"additional","affiliation":[{"name":"School of Technology and Management, Polytechnic Institute of Viseu , Viseu"},{"name":"Centre for Mathematics, University of Coimbra , Coimbra"}]},{"given":"Ana","family":"Matos","sequence":"additional","affiliation":[{"name":"School of Technology and Management, Polytechnic Institute of Viseu , Viseu"},{"name":"CISeD\u2014Research Centre in Digital Services, Polytechnic of Viseu, Viseu, Portugal"}]},{"given":"V\u00e9ronique","family":"Le Guern","sequence":"additional","affiliation":[{"name":"APHP, Internal Medicine Department, Cochin Hospital, Paris, France; Universit\u00e9 de Paris , Paris, France"}]},{"given":"Francisco","family":"Rubi\u00f1o","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Doctor Negr\u00edn University Hospital, Las Palmas de Gran Canaria , Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2782-6780","authenticated-orcid":false,"given":"Jos\u00e9 A P","family":"da Silva","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Centro Hospitalar e Universit\u00e1rio de Coimbra , Coimbra"},{"name":"Faculty of Medicine, University of Coimbra , Coimbra, Portugal"}]},{"given":"I\u00f1igo","family":"Rua-Figueroa","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Doctor Negr\u00edn University Hospital, Las Palmas de Gran Canaria , Spain"}]},{"given":"Nathalie","family":"Costedoat-Chalumeau","sequence":"additional","affiliation":[{"name":"APHP, Internal Medicine Department, Cochin Hospital, Paris, France; Universit\u00e9 de Paris , Paris, France"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0548-4983","authenticated-orcid":false,"given":"Andrea","family":"Doria","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, University of Padova , Padova, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3172-3570","authenticated-orcid":false,"given":"Lu\u00eds S","family":"In\u00eas","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Centro Hospitalar e Universit\u00e1rio de Coimbra , Coimbra"},{"name":"Faculty of Health Sciences, University of Beira Interior , Covilh\u00e3, 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