Change in therapy has been chosen as the reference standard for disease activity and used as the response (outcome) variable. This is based on the well-defined benchmark for active disease, which is the decision to treat and is in line with the previous study that derived the scoring for the Classic BILAG index [6 (link)].
A robust definition for change in therapy was used, similar to the definition used in our previous study [6 (link)]. Change in therapy was the change in treatment following the assessment. The medications of interest included immunosuppressives, anti-malarials, glucocorticoids, biological therapy, topical glucocorticoids, topical immunosuppressives, intravenous immunoglobulins, plasmapheresis, anti-coagulation, prasterone, thalidomide and retinoids. NSAIDs were not included as they are commonly used to treat non-lupus indications (especially for pain relief) and some could be obtained as non-prescription medication. For this analysis, change in therapy was categorized into ‘increase in therapy’ and ‘no increase in therapy’.
A robust definition for change in therapy was used, similar to the definition used in our previous study [6 (link)]. Change in therapy was the change in treatment following the assessment. The medications of interest included immunosuppressives, anti-malarials, glucocorticoids, biological therapy, topical glucocorticoids, topical immunosuppressives, intravenous immunoglobulins, plasmapheresis, anti-coagulation, prasterone, thalidomide and retinoids. NSAIDs were not included as they are commonly used to treat non-lupus indications (especially for pain relief) and some could be obtained as non-prescription medication. For this analysis, change in therapy was categorized into ‘increase in therapy’ and ‘no increase in therapy’.