Systemic lupus erythematosus (SLE) activity assessment often hinges on accurately identifying arthritis, a common manifestation, according to study authors. This study, which was published online in Rheumatology, emphasized the need to refine the SLE Disease Activity Index (SLEDAI) arthritis definition, using imaging and clinical data for precision. The research evaluated the diagnostic accuracy of clinical assessments against musculoskeletal ultrasound findings in SLE patients with inflammatory joint pain. Findings revealed that the current definition may overestimate arthritis due to reliance on subjective symptoms like tenderness and reported swelling, rather than on observed swelling verified by objective measures. Importantly, observed swelling correlated with higher sensitivity and specificity for ultrasound-confirmed synovitis, highlighting its diagnostic relevance.
The study authors proposed a revised definition for SLEDAI arthritis to improve clinical trial outcomes and patient management. The suggested criteria are: “Inflammatory musculoskeletal pain (symmetrical small joint distribution), with one or more clinically swollen joints witnessed on examination, not explained by another arthropathy.”
This revision aligns with imaging findings and optimizes sensitivity and specificity by setting a lower threshold of one swollen joint for defining synovitis. The adoption of this definition could enhance trial inclusion criteria, improve therapy response assessments, and provide more reliable endpoints for evaluating treatment efficacy in non-renal SLE studies, they noted
