International consensus for a definition of disease flare in lupus

The Lupus Foundation of America (LFA) convened an international working group to obtain a consensus definition of disease flare in lupus. With help from the Paediatric Rheumatology International Trials Organization (PRINTO), two web-based Delphi surveys of physicians were conducted. Subsequently, th...

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Bibliographic Details
Published in:Lupus 2011-04, Vol.20 (5), p.453-462
Main Authors: Ruperto, N, Hanrahan, LM, Alarcón, GS, Belmont, HM, Brey, RL, Brunetta, P, Buyon, JP, Costner, MI, Cronin, ME, Dooley, MA, Filocamo, G, Fiorentino, D, Fortin, PR, Franks, AG, Gilkeson, G, Ginzler, E, Gordon, C, Grossman, J, Hahn, B, Isenberg, DA, Kalunian, KC, Petri, M, Sammaritano, L, Sánchez-Guerrero, J, Sontheimer, RD, Strand, V, Urowitz, M, von Feldt, JM, Werth, VP, Merrill, JT
Format: Article
Language:English
Subjects:
Acute Disease
Clinical trials
Delphi Technique
Disease
Humans
Internationality
Lupus
Lupus Erythematosus, Systemic - diagnosis
Medical research
Medicine
Pediatrics
Physicians
Rheumatology
Terminology as Topic
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Summary:The Lupus Foundation of America (LFA) convened an international working group to obtain a consensus definition of disease flare in lupus. With help from the Paediatric Rheumatology International Trials Organization (PRINTO), two web-based Delphi surveys of physicians were conducted. Subsequently, the LFA held a second consensus conference followed by a third Delphi survey to reach a community-wide agreement for flare definition. Sixty-nine of the 120 (57.5%) polled physicians responded to the first survey. Fifty-nine of the responses were available to draft 12 preliminary statements, which were circulated in the second survey. Eighty-seven of 118 (74%) physicians completed the second survey, with an agreement of 70% for 9/12 (75%) statements. During the second conference, three alternative flare definitions were consolidated and sent back to the international community. One hundred and sixteen of 146 (79.5%) responded, with agreement by 71/116 (61%) for the following definition: “A flare is a measurable increase in disease activity in one or more organ systems involving new or worse clinical signs and symptoms and/or laboratory measurements. It must be considered clinically significant by the assessor and usually there would be at least consideration of a change or an increase in treatment.” The LFA proposes this definition for lupus flare on the basis of its high face validity.
ISSN:0961-2033
1477-0962
DOI:10.1177/0961203310388445