Advances in the assessment of lupus disease activity and damage

PURPOSE OF REVIEW: To provide an update on the advances in the assessment of disease activity and damage in systemic lupus erythematosus. RECENT FINDINGS: Over the last couple of years, the development of composite responder indices has led to better description of the changes in disease activity, especially for clinical trials. It has been recognized that newer composite responder indices such as Systemic Lupus Erythematosus Responder Index (SRI) and BILAG-based Combined Lupus Assessment (BICLA) capture more comprehensive clinical response as they integrate global lupus assessment, system-based assessment, physician's global assessment and treatment failure defined as an increase in the dose of steroid and/or immunosuppressant. The Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) Responder Index 50 (SRI-50) may be more practical for capturing response in clinical practice. British Isles Lupus Assessment Group 2004 (BILAG 2004) Index may capture flare slightly better than the other available flare indices whilst also capturing response. SUMMARY: This review will provide an insight into the various tools available to assess disease activity and damage in lupus, with a particular focus on the new responder indices currently in use.