OBJECTIVES: The BILAG index is a clinical measure of lupus disease activity. It is valid, reliable and sensitive to change. Scoring in the BILAG index is based upon the physician's intention to treat. A flare of active lupus is defined as a new A or B score in at least one system. The main aim of this study was to determine whether patients with a lupus flare are treated as expected from the principles upon which the scoring system was devised. Secondly we wanted to establish whether patients with a new B score preceded by a C should be considered to have flared, as with patients scoring B following a D or E score. METHODS: Over a 12-month period, 250 patients regularly attending lupus clinics in Birmingham and London were assessed using the BILAG index at each visit. RESULTS: A new A or B score was observed in 154 (61.6%) patients. An A flare was observed in 26 (10.4%) patients. A B flare (in which the B score was preceded by a D or E score) was observed in 65 (26.0%) patients. There were 63 (25.2%) patients in whom there was a B score in a system in which a C score was previously recorded. Steroids were started or increased in 20 (77%) patients with an A flare. Almost all (92%) patients with a new A score had some increase in therapy. For the patients with new B scores, 53 (41%) had some increase in therapy, but multiple reasons were found for no change in therapy in 75 (59%) of these patients. There was no difference in the treatment of new B scores arising after a previous C score compared with previous D or E scores. Non-Caucasians were more likely to have a lupus flare than Caucasians. CONCLUSIONS: These results are consistent with the principles upon which the BILAG index was devised and suggest that a moderate disease flare can be defined as a new B score following a C, D or E score according to the BILAG index.
OBJECTIVES: The BILAG index is a clinical measure of lupus disease activity. It is valid, reliable and sensitive to change. Scoring in the BILAG index is based upon the physician's intention to treat. A flare of active lupus is defined as a new A or B score in at least one system. The main aim of this study was to determine whether patients with a lupus flare are treated as expected from the principles upon which the scoring system was devised. Secondly we wanted to establish whether patients with a new B score preceded by a C should be considered to have flared, as with patients scoring B following a D or E score. METHODS: Over a 12-month period, 250 patients regularly attending lupus clinics in Birmingham and London were assessed using the BILAG index at each visit. RESULTS: A new A or B score was observed in 154 (61.6%) patients. An A flare was observed in 26 (10.4%) patients. A B flare (in which the B score was preceded by a D or E score) was observed in 65 (26.0%) patients. There were 63 (25.2%) patients in whom there was a B score in a system in which a C score was previously recorded. Steroids were started or increased in 20 (77%) patients with an A flare. Almost all (92%) patients with a new A score had some increase in therapy. For the patients with new B scores, 53 (41%) had some increase in therapy, but multiple reasons were found for no change in therapy in 75 (59%) of these patients. There was no difference in the treatment of new B scores arising after a previous C score compared with previous D or E scores. Non-Caucasians were more likely to have a lupus flare than Caucasians. CONCLUSIONS: These results are consistent with the principles upon which the BILAG index was devised and suggest that a moderate disease flare can be defined as a new B score following a C, D or E score according to the BILAG index.
Authors: Amy H Kao; Jeannine S Navratil; Margie J Ruffing; Chau-Ching Liu; Douglas Hawkins; Kathleen M McKinnon; Natalya Danchenko; Joseph M Ahearn; Susan Manzi Journal: Arthritis Rheum Date: 2010-03
Authors: Hermine I Brunner; Rina Mina; Clarissa Pilkington; Michael W Beresford; Andreas Reiff; Deborah M Levy; Lori B Tucker; B Anne Eberhard; Angelo Ravelli; Laura E Schanberg; Claudia Saad-Magalhaes; Gloria C Higgins; Karen Onel; Nora G Singer; Emily von Scheven; Lukasz Itert; Marisa S Klein-Gitelman; Marilynn Punaro; Jun Ying; Edward H Giannini Journal: Arthritis Care Res (Hoboken) Date: 2011-09 Impact factor: 4.794
Authors: Claas H Hinze; Michiko Suzuki; Marisa Klein-Gitelman; Murray H Passo; Judyann Olson; Nora G Singer; Kathleen A Haines; Karen Onel; Kathleen O'Neil; Earl D Silverman; Lori Tucker; Jun Ying; Prasad Devarajan; Hermine I Brunner Journal: Arthritis Rheum Date: 2009-09
Authors: Daniel J Wallace; William Stohl; Richard A Furie; Jeffrey R Lisse; James D McKay; Joan T Merrill; Michelle A Petri; Ellen M Ginzler; W Winn Chatham; W Joseph McCune; Vivian Fernandez; Marc R Chevrier; Z John Zhong; William W Freimuth Journal: Arthritis Rheum Date: 2009-09-15
Authors: Richard A Furie; Michelle A Petri; Daniel J Wallace; Ellen M Ginzler; Joan T Merrill; William Stohl; W Winn Chatham; Vibeke Strand; Arthur Weinstein; Marc R Chevrier; Z John Zhong; William W Freimuth Journal: Arthritis Rheum Date: 2009-09-15
Authors: Paul J Martin; Carlos R Bachier; Hans-Georg Klingemann; Philip L McCarthy; Paul Szabolcs; Joseph P Uberti; Michael W Schuster; Daniel Weisdorf; Nelson J Chao; Partow Kebriaei; Elizabeth J Shpall; Margaret L Macmillan; Robert J Soiffer Journal: Biol Blood Marrow Transplant Date: 2009-05-13 Impact factor: 5.742