SLE disease modification framework: Delphi consensus

Results from two cross-sectional Delphi surveys of expert systemic lupus erythematosus (SLE) and lupus nephritis (LN) physicians were published in Lupus by Pons-Estel et al. Experts from Argentina, Bahrain, Brazil, Mexico, Oman, Saudi Arabia, and the United Arab Emirates participated in surveys conducted with a workshop discussion between them, evaluating consensus of the SLE and LN disease modification concepts.

Key data: Strong consensus was achieved across all queried statements on disease modification concepts, with some minor regional differences. Experts unanimously agreed that early diagnosis, early referral to a lupus specialist, and a multidisciplinary approach are key factors for achieving disease modification and better patient outcomes. Aspects of the published SLE/LN disease modification definitions were either “routinely” (31%) or “sometimes” (62%) assessed in current clinical practice. Experts agreed that biomarkers are a key component of evaluating disease modification (91%), but there was consensus that available biomarkers are suboptimal (96%).

Key learning: The concept of disease modification can provide a valuable framework to support clinicians in managing patients with SLE and LN, with experts emphasizing the need for clear guidance on applying the framework to routine clinical practice in varying local healthcare systems.