title: International consensus for a definition of disease flare in lupus.
abstract: The Lupus Foundation of America (LFA) convened an international working group to obtain a consensus definition of disease flare in lupus. With help from the Paediatric Rheumatology International Trials Organization (PRINTO), two web-based Delphi surveys of physicians were conducted. Subsequently, the LFA held a second consensus conference followed by a third Delphi survey to reach a community-wide agreement for flare definition. Sixty-nine of the 120 (57.5%) polled physicians responded to the first survey. Fifty-nine of the responses were available to draft 12 preliminary statements, which were circulated in the second survey. Eighty-seven of 118 (74%) physicians completed the second survey, with an agreement of 70% for 9/12 (75%) statements. During the second conference, three alternative flare definitions were consolidated and sent back to the international community. One hundred and sixteen of 146 (79.5%) responded, with agreement by 71/116 (61%) for the following definition: "A flare is a measurable increase in disease activity in one or more organ systems involving new or worse clinical signs and symptoms and/or laboratory measurements. It must be considered clinically significant by the assessor and usually there would be at least consideration of a change or an increase in treatment." The LFA proposes this definition for lupus flare on the basis of its high face validity.
authors.affiliation: Gaslini Pediatria II, Reumatologia, PRINTO, Genova, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Ruperto
authors.forename: L M
authors.initials: LM
authors.lastname: Hanrahan
authors.forename: G S
authors.initials: GS
authors.lastname: Alarcón
authors.forename: H M
authors.initials: HM
authors.lastname: Belmont
authors.forename: R L
authors.initials: RL
authors.lastname: Brey
authors.forename: P
authors.initials: P
authors.lastname: Brunetta
authors.forename: J P
authors.initials: JP
authors.lastname: Buyon
authors.forename: M I
authors.initials: MI
authors.lastname: Costner
authors.forename: M E
authors.initials: ME
authors.lastname: Cronin
authors.forename: M A
authors.initials: MA
authors.lastname: Dooley
authors.forename: G
authors.initials: G
authors.lastname: Filocamo
authors.forename: D
authors.initials: D
authors.lastname: Fiorentino
authors.forename: P R
authors.initials: PR
authors.lastname: Fortin
authors.forename: A G
authors.initials: AG
authors.lastname: Franks
authors.forename: G
authors.initials: G
authors.lastname: Gilkeson
authors.forename: E
authors.initials: E
authors.lastname: Ginzler
authors.forename: C
authors.initials: C
authors.lastname: Gordon
authors.forename: J
authors.initials: J
authors.lastname: Grossman
authors.forename: B
authors.initials: B
authors.lastname: Hahn
authors.forename: D A
authors.initials: DA
authors.lastname: Isenberg
authors.forename: K C
authors.initials: KC
authors.lastname: Kalunian
authors.forename: M
authors.initials: M
authors.lastname: Petri
authors.forename: L
authors.initials: L
authors.lastname: Sammaritano
authors.forename: J
authors.initials: J
authors.lastname: Sánchez-Guerrero
authors.forename: R D
authors.initials: RD
authors.lastname: Sontheimer
authors.forename: V
authors.initials: V
authors.lastname: Strand
authors.forename: M
authors.initials: M
authors.lastname: Urowitz
authors.forename: J M
authors.initials: JM
authors.lastname: von Feldt
authors.forename: V P
authors.initials: VP
authors.lastname: Werth
authors.forename: J T
authors.initials: JT
authors.lastname: Merrill
mesh_terms: D000208:Acute Disease; D003697:Delphi Technique; D006801:Humans; D038622:Internationality; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis*; D009626:Terminology as Topic