Lupus & antiphospholipid syndrome
Patient–physician discordance in assessing SLE disease activity: longitudinal analysis of disease-related variables and quality of life
Authors' conclusion
Discordance between PaGA and PGA was frequent, stable over time and associated with subjective health factors and medication use, but not with damage.
Study context
- Population
- Patients in the Amsterdam SLE cohort with at least 5 years of follow-up
- Participants
- 193 patients
- Exposure
- Patient global assessment (PaGA) vs physician global assessment (PGA) of SLE disease activity
- Outcome
- Discordance between PaGA and PGA (absolute PaGA - PGA difference ≥2), positive (PaGA > PGA), negative (PaGA < PGA) or concordant
Methodological detailslinear and logistic mixed-effects models, at least 5 years of follow-up
- Linear and logistic mixed-effects models
- At least 5 years of follow-up
Main finding
As reported in the abstract
Discordance
55.3%
Positive discordance (PaGA > PGA)
48.6%
Observational data: associations, not effects.
Further findings
Median
| Outcome | PaGA | PGA | P value |
|---|---|---|---|
| PaGA vs PGA scores | 3 | 1 | P < 0.001 |
Factors associated with discordance
- Discordance independently associated with older age at diagnosis, lower SF-36 scores and GC and NSAID use
- PGA higher with greater SLEDAI-2K scores and more frequent GC or NSAID use; PaGA lower with higher SF-36 scores, not influenced by damage
PaGA ≥3 during DORIS remission (subgroup)
- Visits in DORIS remission with PaGA ≥3
- 38%
Original publication
Patient–physician discordance in assessing SLE disease activity: longitudinal analysis of disease-related variables and quality of life. Rheumatology (Oxford). Published 12 December 2025. doi:10.
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