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Treat to target, remission and low disease activity in SLE

Eric F Morand1, Marta Mosca2

  • 1Centre for Inflammatory Diseases, Monash University School of Clinical Sciences, Monash Medical Centre, Melbourne, Australia.

Best Practice & Research. Clinical Rheumatology
|December 12, 2017
PubMed

Insights

Systemic lupus erythematosus (SLE) treatment needs improvement. Treat-to-target (T2T) approaches are promising, with validated low disease activity definitions showing utility for SLE research.

Area of Science:

  • Rheumatology
  • Immunology
  • Clinical Trials

Background:

  • Contemporary systemic lupus erythematosus (SLE) treatments yield suboptimal patient outcomes despite survival improvements.
  • The adoption of treat-to-target (T2T) strategies in SLE is hindered by the absence of validated therapeutic targets.
  • Establishing clear definitions for low disease activity and remission is crucial for advancing SLE management.

Purpose of the Study:

  • To review recent advancements in T2T approaches for SLE.
  • To discuss emerging consensus on definitions for remission and low disease activity in SLE.
  • To evaluate the utility and validity of defined states for SLE research and clinical practice.

Main Methods:

  • Review of recent literature on T2T strategies in SLE.
  • Analysis of evidence-based consensus on definitions of remission and low disease activity.
  • Assessment of the validity and utility of the lupus low disease activity state (LLDAS) definition.

Main Results:

  • Significant progress has been made in T2T approaches for SLE.
  • The lupus low disease activity state (LLDAS) definition demonstrates utility and validity for SLE research.
  • Further work is required to validate improved outcomes from T2T studies in routine clinical care.

Conclusions:

  • Validated definitions for low disease activity and remission are essential for T2T implementation in SLE.
  • The LLDAS definition shows promise for advancing SLE research and potentially clinical practice.
  • Translating T2T benefits into routine SLE care necessitates further clinical validation of outcome improvements.
Keywords:
Low disease activityRemissionSystemic lupus erythematosusTreat to target

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