title: Evaluation of the patient acceptable symptom state (PASS) in Italian patients affected by systemic lupus erythematosus: association with disease activity indices.
abstract: OBJECTIVE
  The aim of this study was to evaluate the discriminant capability of the patient acceptable symptom state (PASS) according to disease activity, in a cohort of Italian patients affected by systemic Lupus erythematosus (SLE).
  
  
  METHODS
  Consecutive SLE patients were enrolled. At each visit, the patients underwent a complete physical examination and the clinical/laboratory data were collected in a standardized, computerized, and electronically-filled form. The evaluation of serum complement C3 and C4 levels and determination of autoantibodies was obtained. Disease activity was assessed with the SLEDAI-2K and ECLAM, while chronic damage was measured with the SLICC. Finally, PASS was assessed in all patients by asking to answer yes or no to a single question.
  
  
  RESULTS
  One hundred sixty-five patients were enrolled (M/F 12/153; mean age 40.4±11.8 years, mean disease duration 109.1±96.2 months). No patients refused to answer, suggesting the acceptability of PASS. A total of 80% of patients rated their state as acceptable. The patients with an acceptable status had significantly lower mean SLEDAI-2K and ECLAM scores than the others [1.8±2.7 versus 3.4±2.3(P=0.004); 0.7±0.9 versus 1.4±1.1(P=0.0027)]. No significant differences were observed when considering chronic damage, evaluated with SLICC.
  
  
  CONCLUSIONS
  In the clinical practice, SLE patients assessment performed by using complex disease activity indices such as SLEDAI-2K and ECLAM, could be time consuming. In our study, for the first time, we used PASS, a quick and easily comprehensible tool, to evaluate the patients' status, this single question seems to be able to discriminate patients with different disease activity, especially when this is determined by musculoskeletal involvement.
authors.affiliation: Lupus Clinic, Reumatologia, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di, Roma, Rome, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Conti
authors.forename: Fulvia
authors.initials: F
authors.lastname: Ceccarelli
authors.forename: Laura
authors.initials: L
authors.lastname: Massaro
authors.forename: Viviana A
authors.initials: VA
authors.lastname: Pacucci
authors.forename: Francesca
authors.initials: F
authors.lastname: Miranda
authors.forename: Simona
authors.initials: S
authors.lastname: Truglia
authors.forename: Enrica
authors.initials: E
authors.lastname: Cipriano
authors.forename: Francesco
authors.initials: F
authors.lastname: Martinelli
authors.forename: Ilaria
authors.initials: I
authors.lastname: Leccese
authors.forename: Francesca Romana
authors.initials: FR
authors.lastname: Spinelli
authors.forename: Cristiano
authors.initials: C
authors.lastname: Alessandri
authors.forename: Carlo
authors.initials: C
authors.lastname: Perricone
authors.forename: Guido
authors.initials: G
authors.lastname: Valesini
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000097:blood; D015331:Cohort Studies; D003176:Complement C3 / Q000032:analysis; D003181:Complement C4 / Q000032:analysis; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
chemical_list: D001323:Autoantibodies; D003176:Complement C3; D003181:Complement C4
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