TY - JOUR
T1 - Physician Global Assessment International Standardisation COnsensus in Systemic Lupus Erythematosus
T2 - the PISCOS study
AU - PISCOS Investigator Group
AU - Piga, Matteo
AU - Chessa, Elisabetta
AU - Morand, Eric F.
AU - Ugarte-Gil, Manuel F.
AU - Tektonidou, Maria
AU - van Vollenhoven, Ronald
AU - Petri, Michelle
AU - Arnaud, Laurent
AU - Appenzeller, Simone
AU - Aranow, Cynthia
AU - Askanase, Anca
AU - Avcin, Tadej
AU - Bae, Sang Cheol
AU - Bertsias, George
AU - Bonfa, Eloisa
AU - Cairoli, Ernesto
AU - Cardiel, Mario H.
AU - Cervera, Ricard
AU - Chasset, François
AU - Chizzolini, Carlo
AU - Clarke, Ann E.
AU - Conti, Fabrizio
AU - Costedoat-Chalumeau, Nathalie
AU - Czirják, László
AU - Doria, Andrea
AU - Dörner, Thomas
AU - Espinosa, Gerard
AU - Fischer-Betz, Rebecca
AU - Garcìa, Mercedes
AU - Gladman, Dafna D.
AU - González, Luis A.
AU - Gunnarsson, Iva
AU - Hamijoyo, Laniyati
AU - Hanly, John G.
AU - Hasni, Sarfaraz A.
AU - Houssiau, Frédéric A.
AU - Inanç, Murat
AU - Inês, Luís S.
AU - Isenberg, David
AU - Jacobsen, Soren
AU - Jan Wu, Yeong Jian
AU - Kaneko, Yuko
AU - Katsumata, Yasuhiro
AU - Lau, Chak S.
AU - Legge, Alexandra C.
AU - Lerang, Karoline
AU - Limper, Maarten
AU - Louthrenoo, Worawit
AU - Luo, Shue Fen
AU - Massardo, Loreto
N1 - Funding Information:
MPe leads the Hopkins Lupus Cohort, which was supported by National Institutes of Health grant R01-AR069572.
Publisher Copyright:
© 2022 Elsevier Ltd
PY - 2022/6
Y1 - 2022/6
N2 - The Physician Global Assessment International Standardisation COnsensus in Systemic Lupus Erythematosus (PISCOS) study aimed to obtain an evidence-based and expert-based consensus standardisation of the Physician Global Assessment (PGA) scoring of disease activity in systemic lupus erythematosus (SLE). An international panel of 79 SLE experts participated in a three-round Delphi consensus process, in which 41 statements related to the PGA in SLE were rated, using a 0 (strongly disagree) to 10 (strongly agree) numerical rating scale. Statements with agreement of 75% or greater were selected and further validated by the expert panel. Consensus was reached on 27 statements, grouped in 14 recommendations, for the use of the PGA in SLE, design of the PGA scale, practical considerations for PGA scoring, and the relationship between PGA values and levels of disease activity. Among these recommendations, the expert panel agreed that the PGA should consist of a 0–3 visual analogue scale for measuring disease activity in patients with SLE in the preceding month. The PGA is intended to rate the overall disease activity, taking into account the severity of active manifestations and clinical laboratory results, but excluding organ damage, serology, and subjective findings unrelated to disease activity. The PGA scale ranges from “no disease activity” (0) to the “most severe disease activity” (3) and incorporates the values 1 and 2 as inner markers to categorise disease activity as mild (≥0·5 to 1), moderate (>1 and ≤2) and severe (>2 to 3). Only experienced physicians can rate the PGA, and it should be preferably scored by the same rater at each visit. The PISCOS results will allow for increased homogeneity and reliability of PGA ratings in routine clinical practice, definitions of remission and low disease activity, and future SLE trials.
AB - The Physician Global Assessment International Standardisation COnsensus in Systemic Lupus Erythematosus (PISCOS) study aimed to obtain an evidence-based and expert-based consensus standardisation of the Physician Global Assessment (PGA) scoring of disease activity in systemic lupus erythematosus (SLE). An international panel of 79 SLE experts participated in a three-round Delphi consensus process, in which 41 statements related to the PGA in SLE were rated, using a 0 (strongly disagree) to 10 (strongly agree) numerical rating scale. Statements with agreement of 75% or greater were selected and further validated by the expert panel. Consensus was reached on 27 statements, grouped in 14 recommendations, for the use of the PGA in SLE, design of the PGA scale, practical considerations for PGA scoring, and the relationship between PGA values and levels of disease activity. Among these recommendations, the expert panel agreed that the PGA should consist of a 0–3 visual analogue scale for measuring disease activity in patients with SLE in the preceding month. The PGA is intended to rate the overall disease activity, taking into account the severity of active manifestations and clinical laboratory results, but excluding organ damage, serology, and subjective findings unrelated to disease activity. The PGA scale ranges from “no disease activity” (0) to the “most severe disease activity” (3) and incorporates the values 1 and 2 as inner markers to categorise disease activity as mild (≥0·5 to 1), moderate (>1 and ≤2) and severe (>2 to 3). Only experienced physicians can rate the PGA, and it should be preferably scored by the same rater at each visit. The PISCOS results will allow for increased homogeneity and reliability of PGA ratings in routine clinical practice, definitions of remission and low disease activity, and future SLE trials.
UR - http://www.scopus.com/inward/record.url?scp=85134577300&partnerID=8YFLogxK
U2 - 10.1016/S2665-9913(22)00107-2
DO - 10.1016/S2665-9913(22)00107-2
M3 - Review article
AN - SCOPUS:85134577300
SN - 2665-9913
VL - 4
SP - e441-e449
JO - The Lancet Rheumatology
JF - The Lancet Rheumatology
IS - 6
ER -