Slicc criteria for sle slicc classification criteria for sle. As the precursor of the slicc group, members of the nato conference on prognosis studies in sle which took place in 1985 in toronto, recognized the need for three instruments to better describe the prognosis of sle including the domains of disease activity, accumulated damage. The total damage in a patient with sle may result from sle itself or from any other pathologic process such as atherosclerosis, hypercoagulability, hypertension, therapy for sle and other comorbid conditions. Creating a definition of systemic lupus erythematosus disease flare led by dr. Background systemic lupus erythematosus sle is a disease with an autoimmune origin, which occurs nine times more often in women than in men, and is especially. Slicc criteria for sle slicc classification criteria for. Slicc acr damage index and the sf36 data were also collected. The slaq, ldiq and the bild are patient selfreport questionnaires, which appear to give similar information to physiciancompleted indices, but are. Use of slicc criteria in a large, diverse lupus registry enables sle classi. Disease activity index sledai8, cumulative organ damage by the acrsystemic lupus international collaborating clinics slicc damage index9, and quality of life by the sf36 1012. The primary outcomes examined were median time to slicc damage index slicc di increase or death during the study period. Firstly can minor damage predict progression to major damage.
Clinics slicc damage index sdi,2 occurs in up to 61% of patients within 7 years of diagnosis of sle, and accrual of damage is predictive of mortality. In order to test their performance, the slicc experts applied the provisional criteria to 690 additional patients with a diagnosis of sle 337 patients or another rheumatologic disease 353 patients. College of rheumatology damage index slicc acedi, lupus damage index questionnaire ldiq, and brief index of lupus damage bild. Factors associated with damage accrual in patients with. Clinics slicc and the american college of rheumatology acr proposed and validated a specific index, the slicc acr damage index sdi 7. We aimed to explore potential areas for intervention to reduce racial disparities with a focus on patient selfefficacy and the quality of patientprovider interactions. Looking for online definition of slicc or what slicc stands for. In a clinical setting, it is a simple tool that enables clinicians to monitor patients in a comprehensive and systematic manner, following the course of damage. Trained physicians must complete it, limiting utility where this is impossible. Risk factors for cataracts in a cohort of egyptian. Clinics slicc group is an international group of investigators dedicated to sle clinical research. Slicc is listed in the worlds largest and most authoritative dictionary database of abbreviations and acronyms the free dictionary.
Slicc classification criteria for sle current medical. Background predictors of poor outcome in systemic lupus erythematosus sle may lead to the identification of highrisk patients at the onset of disease incident cases andor when we first assess them in our clinics prevalent cases. The slicc criteria for sle classification requires. In 1994, a weighted scoring system for slicc acr damage index was presented 2, based upon the opinion of lupus experts. Significant racial disparities exist in sle outcomes. The systemic lupus international collaborating clinics slicc is an international group dedicated to sle clinical research. The slicc acr damage index for sle is an instrument developed for the evaluation of accumulated damage over time. Smoking status predicts earlier slicc damage index. The outcomes were survival or late mortality within the following median observation period of 7 years. Determine body mass index and body surface area using du bois method ideal body weight weightbased medication dosing adjust medication dose based on patient weight body surface area based dosing medication dose adjustment based on body surface area bsa. Derivation and validation of systemic lupus international. Systemic lupus diagnostic criteria slicc calculator.
Sliccacr damage index in childhood sle request pdf. Our retrospective study, based on the slicc acr damage index, was undertaken to investigate the following four questions. Slicc damage index score in systemic lupus erythematosus. To test the reliability of the systemic lupus international collaborating clinicsamerican college of rheumatology slicc acr damage index and the systemic lupus erythematosus disease activity index sledai in the assessment of patients with sle. Typical pleurisy for more than 1 day or pleural effusions or pleural rub. Acr endorsed criteria american college of rheumatology. A novel, diseasespecific qualityoflife instrument for. From 17 studies reporting damage at more than 2 time points, damage. Prior to the 1985 conference on prognosis studies, the partici pants were asked to assess the importance of individual items that might be included in a damage index 7. Slicc damage index 1 08 chronic medical illness cerebrovascular disease 3 18. The systemic lupus international collaborating clinics.
Each patient was examined by 6 of 10 physicians from 5 countries, representing 10 lupus clinics. The slicc noted the following concerns about the acr criteria 7. Early disease and low baseline damage predict response to. Pdf version slicc classification criteria for sle amith balachandran, department of anaesthesia, cmc vellore, and ashish jacob mathew, assistant professor, department of rheumatology, cmc, vellore. The aims of this study were to determine damage index in systemic lupus erythematosus sle patients based on systemic lupus international collaborating clinicsamerican college of rheumatology slicc acr damage index sdi and to determine the laboratory and clinicodemographic factors affecting sdi this is a retrospective cohort study of 94 sle patients attending rheumatology clinics in. Clinical variables were the n compared between the two groups to identify potential risk factors for damage. The sdi contains items that represent permanent, irreversible damage in a lupus patient that have occurred after the diagnosis of sle 3. At 5 yr, the mean renal ds in afrocaribbeans and the mean neuropsychiatric ds in asians were significantly higher than in caucasians. Methods the systemic lupus international collaborating clinics slicc inception cohort recruited patients within 15 months of developing four or more 1997 american college of rheumatology acr criteria for sle. The aim of this study was to investigate whether initial and accrued organ damage measured by systemic lupus international collaborating clinics slicc damage index sdi predicts mortality in. The slicc damage index sdi is a validated instrument for assessing organ damage in systemic lupus erythematosus sle.
Accaha cv risk calculator 20 estimate 10year risk for atherosclerotic cardiovascular disease revised cardiac risk index lee criteria rapid preop assessment using the revised cardiac risk index asymptomatic ica internal carotid artery stenosis surgical risk stratification gupta perioperative cardiac risk determine perioperative risk for a wide array of surgeries. Electronic health records ehr were manually abstracted and patients meeting either acr 1987 or slicc 2012 classification criteria for sle were included in analysis. In contrast to inflammatory disease activity, where a number of validated instruments are used, damage is principally assessed with a single validated tool, the slicc acr damage index sdi. In the overall cohort, glucocorticoid use was independently associated with accrual of irreversible organ damage, measured by systemic lupus international collaborating clinics damage index sdi, after adjusting for measurable disease activity. In this inception cohort 198 patients were identified and were followed for 10 years. The 2012 revised slicc criteria for classification of.
In all patients the slicc american college of rheumatology acr damage index di was scored at 5 years after sle diagnosis, and these scores were tested for predictive value. The reliability of the systemic lupus international. Typical pericardial pain pain with recumbency improved by sitting forward for more than 1 day or pericardial effusion or pericardial rub or pericarditis by electrocardiography. Or tenderness in 2 or more joints and at least 30 minutes of morning stiffness.
Ten patients with sle, representing a spectrum of damage and activity, were included. Clinical course of coronavirus disease 2019 covid19 in. In an intensive process of evaluation, the slicc experts validated the preliminary criteria based on a second independent data set. Development of the slicc american college of rheumatology acr damage index sdi in 1996 led by dr. In an early sle cohort the acr1997, slicc 2012 and eularacr2019 criteria classify nonoverlapping groups of patients. Early renal damage assessed by the sliccacr damage index. Few studies have examined modifiable factors intrinsic to physicianpatient encounters that may contribute to such disparities.
A list of items that should be included in a damage index, with. The rate of endstage renal failure in caucasians was significantly lower than in the other ethnic groups. Studies highlight risk of damage from lupus treatments. Objective to investigate predictors of response, remission, low disease activity lda, damage and drug discontinuation in patients with systemic lupus erythematosus sle treated with belimumab. The slicc acr damage index for sle was developed to assess accumulated damage since the onset of the disease. In the text below the form there is information on the slicc, along with instructions on how to interpret the criteria that is present.
This group produced tools that form the basis of outcome studies in sle today, such as the slicc acr damage index 12. Presence of disease damage was defined as a sdi score of. Longitudinal analysis of correlation between lldas and slicc damage index scores. Clinics slicc damage index sdi between randomisation and week 52. Racial disparities in factors associated with slicc damage. Request pdf on nov 1, 2010, i venkatesh and others published slicc acr damage index in childhood sle find, read and cite all the research you need on researchgate. Use of slicc criteria in a large, diverse lupus registry. Studies using such index in sle cohorts demonstrated that damage accrual is associated with several demographic. See information about the purpose of criteria sets. Fatigue was measured on a 10 point likert scale from 0 not at all to 10 yes, completely in response to the statement. This current study included 1,700 patients from the cohort who had a minimum of one followup visit in addition to their enrollment visit and a slicc damage index sdi score recorded at least once. High predictive value of the systemic lupus international. In an early sle cohort the acr1997, slicc2012 and eular.
The systemic lupus international collaborating clinics slicc damage index. Withdrawal of lowdose prednisone in sle patients with a. The slicc systemic lupus international collaborating clinics is an international research group that is over 30 years old, which is dedicated to sle and has contributed much to this field, including development of the acr slicc damage index 6. Slicc acr damage index 1996 1997 update of 1982 revised criteria for classification of sle. This systemic lupus diagnostic criteria slicc calculator helps the classification and diagnosis of sle based on clinical and immunological criteria. The slicc damage index at a cutoff point 2 and a cumulative css dose at a cutoff point 63.
Development of the slicc classification criteria for systemic lupus erythematosus in 2012 led by dr. Gladman was a key facilitator in the development and validation of the slicc acr damage index. We tested whether the lupus severity index lsi can help characterize high versus low risk lupus patients. The aims of this study were to determine damage index in systemic lupus erythematosus sle patients based on systemic lupus international collaborating clinicsamerican college of rheumatology slicc acr damage index sdi and to determine the laboratory and clinicodemographic factors affecting sdi. Our results confirm the validity of the slicc acr damage index. Risk factors for damage in childhoodonset systemic lupus. The damage includes nonreversible changes in organs and systems affected by the disease process itself, its therapy, or intercurrent illness. This paper describes the development of the damage index, its validation and its use.
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