OP0293 OPTIMIZING A TOOL TO IDENTIFY LUPUS FLARES IN DAILY CLINICAL PRACTICE: SLE-DAS FLARE VERSUS SELENA FLARE INDEX

Background: In the management of patients with Systemic Lupus Erythematosus (SLE), it is utmost importance to accurately identify lupus flares. There a conceptual consensus definition flares [1]; however, instruments used in clinical trials, such as SELENA Flare Index (SFI) are too cumbersome apply daily practice. The SLE disease activity score (SLE-DAS) validated continuous measure higher sensitivity change and validity predicting damage accrual when compared SLEDAI-2K. SLE-DAS quickly scored its online calculator. An increase ?1.72 was clinically meaningful worsening activity. [2] Objectives: To compare performance SLE-DAS, classic SFI (c-SFI), revised (r-SFI) SLEDAI-2K identification real-life setting. Methods: We included fulfilling classification criteria [ACR (1997) and/or SLICC EULAR/ACR], followed at an academic clinic from January 2017 June 2020, presenting low (LLDAS) baseline. Flares occurring after baseline were identified fulfillment flare, assessed by senior expert time each outpatient visit. For flare event, we evaluated according c-SFI, r-SFI, (score ?4 points baseline), baseline). As control visits without considered first visit baseline, where four tools, excluding those gold-standard evaluation. Sensitivity specificity tools estimated McNemar’s test applied assess differences definition. inter-instrument agreement through Cohen’s Kappa. Results: 297 (female: 86.2%; mean age: 48.9±14.6 years, duration: 12.5±9.0 years). At all LLDAS, receiving ongoing antimalarials, immunosuppressants, glucocorticoids 91.0%, 43.8% 33.6%, respectively. During follow-up, 22.2% developed analysis 92 [musculoskeletal (40.2%); renal (23.9%), mucocutaneous (18.5%), haematological (5.9%), serositis (3.3%); multisystemic (8.7%)], or treatment 80.4% these episodes, 292 control. no statistically significant difference between either c-SFI (p=0.41 p=0.82, respectively), while r-SFI different (Table 1). strong (Cohen’s kappa, Table 1. Performance for (%) Specificity §§ Kappa § 90.1 95.0 n.s. 0.836 91.1 96.5 0.869 93.4 92.9 p<0.01 0.820 51.6 98.6 p<0.0001 0.590 test: if p<0.05; kappa (0-1) definition; n.s.: non-significant Conclusion: showed best identifying easier hence might be optimal tool References: [1]Ruperto N, Hanrahan LM, Alarcón GS, et al. International lupus. . 2011;20(5):453-62. [2]Jesus D, Matos A, Henriques C, Derivation validation Disease Activity Score (SLE-DAS): new high changes Ann Rheum Dis 2019; 78:365-71. Disclosure Interests: None declared.