A new test may be able to predict the severity of lupus and whether the disease is active. In a collaborative effort, Columbia University Medical Center, the Oklahoma Medical Research Foundation and the Lupus Foundation of America are developing the test, called LFA rapid evaluation of activity in lupus (LFAREAL). It may eventually be used by doctors to monitor their patients and in clinical trials testing medications for lupus.
Systemic lupus erythematosus (SLE) is an autoimmune disease of unknown cause. It is more common in women than men, and in African Americans and Asians compared to other races. It most commonly appears between the ages of 10 and 50.
Establishing a way to assess and identify SLE has been a major challenge for both researchers and health care providers. It is difficult to predict the course of the disease, which can flare up and reside, and may even lead to unexpected death in some cases.
Researchers and doctors need better and more sensitive measurements to assess the activity of SLE in clinical trials and in clinical practice. The LFAREAL may offer researchers and physicians alike an easier diagnostic method. The system is made up of visual analogue scores that can be used for each organ affected by lupus. In a visual analogue, the rater can assess how bad a problem is by pointing to a continuum of values.
In a study of how well LFAREAL preformed in measuring lupus disease activity, the researchers compared it with the most widely used measurements currently used in clinical trials. This included the British Isles Lupus Assessment Group 2004 Index (BILAG), the SLE Disease Activity Index (SLEDAI) and the Safety of Estrogens in Lupus Erythematosus National Assessment (SELENA) SLEDAI Physician’s Global Assessment (SS-PGA).
The researchers used statistical tests to compare the different tools for measuring lupus disease activity.
The team evaluated a total of 91 people with SLE with disease activity ranging from mild to severe. Of these, thirty-three people had moderate to severe disease activity. The total LFAREAL corresponded well with the other measurements, including SLEDAI, BILAG and SSPGA. Scores for individual organs measured using the LFAREAL, muscle, skeletal, skin and mucus membranes, specifically corresponded with BILAG scores.
In their study report, the scientists concluded that “In this preliminary exercise, there were strong correlations between LFA-REAL and validated lupus disease activity indices. Further development may be valuable for consistent scoring in clinical trials, grading optimal assessment of change in disease activity and reliable monitoring of patients in practice.”
The LFAREAL may be a valuable new tool that can help doctors monitor and treat patients, and may aid in the development of new treatments for SLE.
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