[Evaluation of the clinical activity of systemic lupus erythematosus]

It is difficult to measure clinical disease activity in systemic lupus erythematosus because many organs can be involved simultaneously and the corresponding symptoms are not easy to quantify. Disease activity is poorly defined and there is no consensus on what disease activity means or how it should be measured. More than 60 systems have been devised but none of them is commonly used because they do not have the 3 characteristics necessary for such a tool: validity, reliability and sensitivity. Three recent systems, BILAG (British Isles Lupus Assessment Group), SLEDAI (Systemic Lupus Erythematosus Disease Activity Index) and SLAM (Systemic Lupus Activity Measures) are very valid. Comparisons of their reproducibility are in progress; however, more information is needed concerning their sensitivity and the feasibility of making these systems easy to manage for physicians.