The Definitions of Remission in SLE (DORIS) group has proposed multiple definitions of remission, but these are infrequently attained and have not been prospectively evaluated in relation to protection from damage accrual. In contrast, the Lupus Low Disease Activity State (LLDAS) is more attainable, and has been shown to be associated with improved patient outcomes.

To compare the attainability, and association with outcomes, of LLDAS and remission in a prospective multicentre study.

A prospective multinational cohort study was undertaken in 13 centres between 2013-2017. Time dependent Cox proportional hazards models were used to compare LLDAS and DORIS definitions of remission in terms of impact on disease flares and damage accrual.

1735 SLE patients were recruited, and followed for (mean±SD) 2.2±0.9 years, totalling 12,717 visits. LLDAS was achieved …