Researchers develop new tool to help monitor systemic lupus erythematosus

Researchers develop new tool to help monitor systemic lupus erythematosus
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Researchers have developed a new, easier, and more accurate tool to measure the progress of systemic lupus erythematosus in patients.

Systemic lupus erythematosus affects up to 1.5 million people in the United States and around one in 1000 people in the United Kingdom. The autoimmune disease causes the body’s immune system to attack its own healthy tissues, especially the joints, skin, and kidneys. To understand the progress of systemic lupus erythematosus and make calculated decisions, doctors will regularly monitor the development. Studies have indicated that controlling the disease leads to less long-term organ damage.

The research was published in Rheumatology, published by Oxford University Press.

An overview of systemic lupus erythematosus

Systemic lupus erythematosus can be difficult to diagnose due to its similarities to other conditions. Symptoms include inflammation of different parts of the body, including the lungs, heart, and liver. The severity of the autoimmune disease can be either mild, moderate, or severe and are categorised by different symptoms:

  • Mild: joint and skin problems, tiredness.
  • Moderate: inflammation of other parts of the skin and body, including your lungs, heart, and kidneys.
  • Severe: inflammation causing severe damage to the heart, lungs, brain, or kidneys and can be life-threatening.

Monitoring disease progression

The standard tool to measure systemic lupus erythematosus disease progression, called the BILAG-2004 index, uses multiple reference documents, including a case report form, a detailed glossary, and separate scoring algorithms covering nine different areas. However, it is often too difficult or time-consuming for doctors to complete during routine clinic visits. It poses a challenge as the standard index can make it difficult for physicians to measure the disease accurately and consistently. In clinical trials, the training required is long, mistakes in scoring are common, and physicians often express frustration with the method.

Researchers developed a new “Easy-BILAG” project to help doctors assess systemic lupus erythematosus using a simple, faster tool. Easy-BILAG is a single-page document using colour-coding to make assessment more user-friendly. The researchers found that, when compared across a variety of factors, the new tool enabled more accurate, consistent, and time-efficient measurements of systemic lupus erythematosus disease progression.

Overall accuracy was boosted to 96% and general hospital rheumatologists could measure disease progression accurately in 91.3% of cases using the new tool, compared with only 75% when using the more difficult standard format. Rheumatologists were able to use the new tool to assess cases faster, in under an hour. The standard format took an average of 80 minutes to complete.

Rheumatologists rated the new tool as intuitive and well adapted for routine clinical practice and expressed willingness to use it routinely. “The standard-format BILAG is useful for assessing individual patients,” said the paper’s author, Edward Vital, “but its downside was always the time and training needed to complete it. Being able to measure the progress of lupus quickly and easily has transformed my practice, so I’m excited that we can now make it easy for anyone to do the same.”

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