BILAG-2004 index captures systemic lupus erythematosus disease activity better than SLEDAI-2000

Research output: Contribution to journalArticle


  • DA Isenberg
  • A Prabu
  • K Sokoll
  • LS Teh
  • A Rahman
  • IN Bruce
  • B Griffiths
  • M Akil
  • N McHugh
  • D D'Cruz
  • MA Khamashta
  • P Maddison
  • A Zoma

Colleges, School and Institutes


OBJECTIVE: To assess the reliability of Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)-2000 index in routine practice and its ability to capture disease activity as compared with the British Isles Lupus Assessment Group (BILAG)-2004 index. METHODS: Patients with systemic lupus erythematosus from 11 centres were assessed separately by two raters in routine practice. Disease activity was assessed using the BILAG-2004 and SLEDAI-2000 indices. The level of agreement for items was used to assess the reliability of SLEDAI-2000. The ability to detect disease activity was assessed by determining the number of patients with a high activity on BILAG-2004 (overall score A or B) but low SLEDAI-2000 score (or=6). Treatment of these patients was analysed, and the increase in treatment was used as the gold standard for active disease. RESULTS: 93 patients (90.3% women, 69.9% Caucasian) were studied: mean age was 43.8 years, mean disease duration 10 years. There were 43 patients (46.2%) with a difference in SLEDAI-2000 score between the two raters and this difference was >or=4 in 19 patients (20.4%). Agreement for each of the items in SLEDAI-2000 was between 81.7 and 100%. 35 patients (37.6%) had high activity on BILAG-2004 but a low SLEDAI-2000 score, of which 48.6% had treatment increased. There were only five patients (5.4%) with low activity on BILAG-2004 but a high SLEDAI-2000 score. CONCLUSIONS: SLEDAI-2000 is a reliable index to assess systemic lupus erythematosus disease activity but it is less able than the BILAG-2004 index to detect active disease requiring increased treatment.


Original languageEnglish
Pages (from-to)873-6
Number of pages4
JournalAnnals of the Rheumatic Diseases
Issue number6
Publication statusPublished - 1 Jun 2008