title: Flare, persistently active disease, and serologically active clinically quiescent disease in systemic lupus erythematosus: a 2-year follow-up study.
abstract: OBJECTIVE
  Several indices have been proposed to assess disease activity in patients with Systemic Lupus Erythematosus (SLE). Recent studies have showed a prevalence of flare between 28-35.3%, persistently active disease (PAD) between 46%-52% and serologically active clinically quiescent (SACQ) disease ranging from 6 to 15%. Our goal was to evaluate the flare, PAD and SACQ rate incidence in a cohort of SLE patients over a 2-year follow-up.
  
  
  METHODS
  We evaluated 394 SLE patients. Flare was defined as an increase in SLEDAI-2K score of ≥4 from the previous visit; PAD was defined as a SLEDAI-2K score of ≥4, on >2 consecutive visits; SACQ was defined as at least a 2-year period without clinical activity and with persistent serologic activity.
  
  
  RESULTS
  Among the 95 patients eligible for the analysis in 2009, 7 (7.3%) had ≥1 flare episode, whereas 9 (9.4%) had PAD. Similarly, among the 118 patients selected for the analysis in 2010, 6 (5%) had ≥1 flare episode, whereas 16 (13.5%) had PAD. Only 1/45 patient (2.2%) showed SACQ during the follow-up.
  
  
  CONCLUSIONS
  We showed a low incidence of flare, PAD and SACQ in Italian SLE patients compared with previous studies which could be partly explained by ethnic differences.
authors.affiliation: Lupus Clinic, Reumatologia, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Conti
authors.forename: Fulvia
authors.initials: F
authors.lastname: Ceccarelli
authors.forename: Carlo
authors.initials: C
authors.lastname: Perricone
authors.forename: Francesca
authors.initials: F
authors.lastname: Miranda
authors.forename: Simona
authors.initials: S
authors.lastname: Truglia
authors.forename: Laura
authors.initials: L
authors.lastname: Massaro
authors.forename: Viviana Antonella
authors.initials: VA
authors.lastname: Pacucci
authors.forename: Virginia
authors.initials: V
authors.lastname: Conti
authors.forename: Izabella
authors.initials: I
authors.lastname: Bartosiewicz
authors.forename: Francesca Romana
authors.initials: FR
authors.lastname: Spinelli
authors.forename: Cristiano
authors.initials: C
authors.lastname: Alessandri
authors.forename: Guido
authors.initials: G
authors.lastname: Valesini
mesh_terms: D000328:Adult; D000974:Antibodies, Antinuclear / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index
chemical_list: D000974:Antibodies, Antinuclear