PO.4.77 Agreement between lldas and expert assessment in identifying SLE patients with LDA: study on a real-world cohort of caucasian patients

PurposeBoth lupus low disease activity state (LLDAS) and remission have been proven to be good and achievable targets in the management of SLE. Nevertheless, considerable overlap between LLDAS and remission exists: an average of 80% of patients in LLDAS also meet the definition of remission in different cohorts worldwide, raising the question whether LLDAS definition is too close to definition of remission. Our aim was to evaluate the performance of LLDAS in identifying patients in LDA, defined according to gold standard, which is physician judgement.MethodsWe prospectively collected data of SLE patients attending our outpatient clinic from October 2021 to January 2022. Each patient received a complete clinical evaluation and review of recent laboratory tests by a rheumatologist expert in SLE, who classified patients in the following states: remission, LDA, active disease. Each category was mutually exclusive. The definitions of LLDAS and remission were also applied. LLDAS was defined, according to Franklyn et al., as SLEDAI-2k≤4 without major organ activity (including renal, cardiac and fever), no new disease activity, PGA≤1 (0–3), stable immunosuppressive therapy and prednisone equivalent dose up to 7.5 mg/day. Remission was defined according to the DORIS definition as clinical SLEDAI-2k=0 and PGA