RT Journal Article SR Electronic T1 SLEDAI-2K Does Not Conceal Worsening in a Particular System When There Is Overall Improvement JF The Journal of Rheumatology JO J Rheumatol FD The Journal of Rheumatology SP 1401 OP 1405 DO 10.3899/jrheum.141088 VO 42 IS 8 A1 Zahi Touma A1 Dafna D. Gladman A1 Jiandong Su A1 Dominique IbaƱez A1 Murray B. Urowitz YR 2015 UL http://www.jrheum.org/content/42/8/1401.abstract AB Objective. To determine whether the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) is valid in identifying patients who had a clinically important overall improvement with no worsening in other descriptors/systems.Methods. Consecutive patients with systemic lupus erythematosus with active disease who attended the Lupus Clinic between 2000 and 2012 were studied. Based on the change in the total SLEDAI-2K scores on last visit, patients were grouped as improved, flared/worsened, and unchanged. Patients showing improvement were evaluated for the presence of new active descriptors at last visit compared with baseline visit.Results. Of the 158 patients studied, 109 patients had improved, 38 remained unchanged, and 11 flared/worsened at last visit. In the improved group, 11 patients had a new laboratory descriptor that was not present at baseline visit. In those 11 patients, this new laboratory descriptor was not clinically significant and did not require a change in disease management.Conclusion. The SLEDAI-2K identifies improvement in disease activity overall without concealing clinically important worsening.