Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)

Safety of Estrogen in Lupus National Assessment - Systemic Lupus Erythematosus Disease Activity Index (SELENA-SLEDAI)

• a measure of lupus activity is called the SLE Disease Activity Index, and the acronym for it is SLEDAI
  • a list of 24 items, 16 of which are clinical items such as seizure, psychosis, organic brain syndrome, visual disturbance, other neurological problems, hair loss, new rash, muscle weakness, arthritis, blood vessel
    inflammation, mouth sores, chest pain worse with deep breathing and manifestations of pleurisy and/or pericarditis and fever
    
    
  • eight of the 24 items are laboratory results such as urinalysis testing, complement levels, increased anti-DNA antibody levels, thrombocytopaenia, and neutropaenia
    
    
  • scored based on whether these manifestations are present or absent in the previous 10 days
    
    
  • organ involvement is weighted; for example, joint pain and kidney disease are each multiplied by four, but central nervous system neurological involvement is multiplied by eight
    • the weighted organ manifestations are then summed into a final score, which can range from zero to 105
    • a SLEDAI of 6 or more has been shown to be consistent with active disease requiring therapy. A clinically meaningful difference has been reported to be an improvement of 6 points or worsening of 8 points
      
      
• the SLEDAI was modified in the Safety of Estrogens in Lupus Erythematosus National Assessment (SELENA) trial; this modification is known as the SELENA-SLEDAI system
  • aims to capture ongoing rather than just new or recurrent activity
  • the SLE Responder Index (SRI) comprises a reduction in SELENA-SLEDAI score of >=4 points (1)

Reference:

• Reynolds JA, Bruce IN. Overview of the management of systemic lupus erythematosus. ARC; 2 (Topical Reviews Series 7) Spring 2013.