Lupus & antiphospholipid syndrome
Revision to the musculoskeletal domain of the BILAG-2004 index to incorporate ultrasound findings
Authors' conclusion
Proposed changes to the definitions of inflammatory arthritis in the BILAG-2004 index will result in more accurate classification of patients who are more or less likely to respond to treatment.
Study context
- Population
- Patients from two recent SLE trials
- Participants
- 219 patients2 SLE trials
- Comparison
- Revised vs original BILAG-2004 musculoskeletal (MSK) domain definitions of inflammatory arthritis
- Outcome
- Impact of the proposed changes on the severity grading of inflammatory arthritis
Methodological detailsexpert subcommittee revision of index definitions, Revised definitions: severe includes definition of 'basic activities of daily living'; moderate includes synovitis by observed joint swelling or MSK US inflammation; mild references symmetrical distribution and US guidance for re-classification
- Expert subcommittee revision of index definitions
- Revised definitions: severe includes definition of 'basic activities of daily living'; moderate includes synovitis by observed joint swelling or MSK US inflammation; mild references symmetrical distribution and US guidance for re-classification
Pooled result
As reported in the abstract
Severity grading of inflammatory arthritis with the revised definitions
Graded as mild inflammatory arthritis (BILAG-2004 Grade C)
119
54.3%
Of Grade C, joint inflammation (synovitis or tenosynovitis) on US
53
44.5%
Classified as moderate inflammatory arthritis, original vs new definition
72 (32.9%) to 125 (57.1%)
Grade C with normal US, could be recategorised as Grade D (inactive disease)
66 of 119
Original publication
Revision to the musculoskeletal domain of the BILAG-2004 index to incorporate ultrasound findings. Rheumatology (Oxford). Published 24 May 2023. doi:10.
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