Ability of SLE-DAS and SLEDAI-2K to predict damage accrual in SLE: A real-world 7-year cohort study from Sweden
In brief
A newer lupus activity score better predicted organ damage over 3 to 7 years
In a Swedish cohort of 335 people with lupus, the SLE Disease Activity Score independently predicted organ damage at 3, 5, and 7 years and outperformed the SLEDAI-2K score at each interval. This retrospective comparison supports its value for risk assessment, but does not show that using the score prevents damage.
- Journal
- Rheumatology (Oxford, England) (Q1)
- Published
- 29 September 2026
- Study design
- Prospective / inception cohort
- Evidence level
- Level 2, Moderate (CEBM 2b)
- Authors
- Rama Andraos, Alexander Tsoi, Alf Kastbom, Martina Frodlund, Diogo Jesus, Luís Sousa Inês, et al.
- PMID
- 42811191
- DOI
- 10.1093/rheumatology/keag545
Why clinicians should know about it
- Picked for Rheumatology (paper of the day, 3 October 2026): SLE‑DAS outperforms SLEDAI‑2K in predicting organ damage
Abstract
OBJECTIVES: SLE remains a heterogeneous autoimmune disease that can lead to irreversible organ damage. SLE Disease Activity Score (SLE-DAS) is a recently developed tool with higher sensitivity to change than SLE Disease Activity Index-2000 (SLEDAI-2K). We compared SLE-DAS with other activity measures in terms of ability to predict organ damage. METHODS: Patients from Linköping University Hospital with ≥2 visits between 2008 and 2025 were included. SLEDAI-2K and Physician's Global Assessment (PhGA) were assessed prospectively, and SLE-DAS retrospectively. Organ damage was estimated annually using the SLICC/ACR Damage Index (SDI). Adjusted mean scores of SLEDAI-2K (amSLEDAI-2K), PhGA (amPhGA), and SLE-DAS (amSLE-DAS) were determined for each time interval between consecutive visits, and their ability to predict damage accrual was evaluated using time-dependent multivariable Cox regression models. Predictive ability was compared across measures using Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC). RESULTS: In total, 335 patients with 3582 outpatient visits contributed data. amSLE-DAS was an independent predictor of SDI increase at the 3- (HR; 95% CI: 1.04; 1.00-1.08), 5- (1.05; 1.01-1.09), and 7-year follow-up (1.04; 1.00-1.08). amSLEDAI-2K was predictive at the 5-year follow-up only (1.12; 1.02-1.22), and amPhGA at 5 (1.99; 1.19-3.36) and 7 (1.84; 1.02-3.30) years. amSLE-DAS showed a higher predictive ability for damage accrual than amSLEDAI-2K at the 3-, 5-, and 7-year follow-up, as indicated by lower AIC and BIC. CONCLUSION: In this real-world Swedish setting, we demonstrate that SLE-DAS outperforms SLEDAI-2K in predicting organ damage accrual in SLE, substantiating its clinical relevance.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.