P129 Does the perspective of SLE patients match the expert opinion and definitions of remission and low disease activity state? Prospective analysis of 500 patients from a Spanish multicenter cohort

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Background No data on agreement between patient perception, DORIS 2021 remission, LLDAS, or physician assessment is currently available. The aim is to compare the SLE activity perceived by the patient using the Patient Acceptable Symptom State (PASS) question with the global assessment of activity by the physician, and the definitions of LLDAS/DORIS2021. Methods A cross-sectional multicenter study involving SLE patients from seven Spanish Rheumatology Departments was conducted. The study applied DORIS 2021 remission criteria and LLDAS. Rheumatologists classified disease activity into five categories: remission, SACQ, low, moderate, or high. The patients were asked about their clinical SLE condition through the PASS question: ‘Considering all the different ways your disease is affecting you, if you were to stay in this state for the next few months, do you consider your current state satisfactory?’: PASS yes/PASS no. Statistical analysis included descriptive cross-sectional analysis and Cohen’s kappa for agreement analysis. Results Among the 503 patients in the study (table 1), 386 (77.4%) reported an acceptable symptom state according to the PASS question. Mean patient global assessment (PtGA) was 29.62 (±24.38) on a scale of 0–100, while mean physician global assessment (PGA) was 0.46 (±0.59) on a scale of 0–3. A total of 236 (47.6%) patients met DORIS 2021 remission criteria, and 289 (59%) met LLDAS. According to the rheumatologists’ categorical classification, 435 (86.8%) patients were in remission or low disease activity (table 2). Among PASS-affirmative patients, 65.5% met LLDAS and 57.9% met DORIS 2021 remission criteria, with lower PtGA (19.7) and PGA (0.29) scores. In the non-PASS group, 62.8% were not in LLDAS, and 87.6% did not meet DORIS 2021 remission criteria, with higher PtGA (58) and PGA (1) scores (table 3). The overall agreement between PASS and categorical classification was 82% with a Cohen’s kappa of 0.43. Conclusions The majority of SLE patients reported an acceptable symptom state according to the PASS question, which aligns with the PtGA scale. Physicians’ assessments also showed similarities with patient perspectives. However, notable differences were observed regarding remission/LLDAS criteria, indicating that while patient and physician perspectives align on subjective classification, variations exist concerning LLDAS and DORIS.

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