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Microsoft powerpoint - multicentre last study v3









Multicenter Validation of the Lupus Activity Scoring Tool (LAST) as Compared to the SELENA SLEDAI (SS) Modification M. KHRAISHI, R. ASLANOV , S. DIXIT , K. FUDGE , V. AHLUWALIA, S. KHRAISHI
NEXUS Clincal Research/NL Research Technologies (NLRT), St. John's, NL; Memorial University of Newfoundland (MUN), St. John's, NL; 1960 Appleby Line, Burlington, ON;
Western Memorial Hospital, Corner Brook, NL; 314-40 Finchgate Blvd., Brampton, ON.
In our centre, a new tool for the assessment of Systemic Lupus Erythematosus (SLE) is a multisystem
Thirty one patients (90.3% females) with 68 assessments from four study centers were included in this analysis. The mean (SD) age was 46.3 (14.7) years and the
SLE activity: the Lupus Activity Scoring Tool autoimmune rheumatic disease (ARD) with flares and
mean (SD) of disease duration was 13.6 (6.1) years. Scores from the LAST were obtained at each visit in addition to the SLEDAI scores. The mean (SD) SLEDAI
(LAST)¹ was developed and validated. This remissions. SLE has versatile and often complex clinical
score was 6.6 (3.9). The mean (SD) LAST (with C3, C4 and Anti-ds Anti-DNA) score was 34.9 (18.2). The SLEDAI scores were consistent and strongly correlated
tool simplifies the approach to quantifying SLE activity while maintaining high sensivity. This manifestations, necessitating careful assessment of
(r=0.791; p<0.001) with the LAST scores at the baseline and follow-up visits: SS scores 0-4 corresponded to the LAST scores of 0-30 while SS scores of 8 or higher
study was designed to validate this tool in disease and its response to treatment. Current disease
corresponded to 50 and higher, respectively. The electronic applications of the LAST were easy to use and no errors were found with their results as compared to
multiple clinical settings. Apple iPad and activity indices (e.g. SELENA SLEDAI, BILAG & SLAM) have
the manually obtained scores.
Windows web-based applications were their own limitations for use in the routine clinical setting. In
developed for the LAST.
our centre, a new tool for the assessment of SLE activity:
We aimed to validate the LAST in multiple GRAPH 1: Correlation of the Scores between SELENA SLEDAI & LAST
clinical settings using its correlation to the the Lupus Activity Scoring Tool (LAST)¹ was developed and
SELENA SLEDAI modification and to test the validated. This tool simplifies the approach to quantifying
The Lupus Activity Scoring Tool (LAST) is a new disease activity index that
usability and the accuracy of an electronic SLE activity while maintaining high sensivity. This study
correlates well with the SELENA SLEDAI modification. The use of simple clinical
application of the same tool. This multicenter was designed to validate this tool in multiple clinical
variables as a measure of SLE activity seems to be valid under different clinical
study was initiated in four Canadian clinics: two settings. Apple iPad and Windows web-based applications
in Newfoundland and two in Ontario.
settings with different assessors. The development of easy to use electronic apps
Patients who met the SLE ACR 1997 criteria were developed for the LAST.
will make the use of these activity tracking tools simpler and can possibly be
update were recruited and evaluated in the utilized in non-specialist settings.
study centres using LAST. Some of the patients were prospectively followed and Paper version of the LAST and C-LAST
evaluated by the same tool at each visit. The Screen-shots from iPad
version of the LAST & C-LAST
LUPUS ACTIVITY SCORING & TRACKING TOOL (LAST) LUPUS ACTIVITY SCORING & TRACKING TOOL (LAST) SS was also calculated for each visit. Primary: To validate the LAST in multiple clinical settings
Patient Name: _
Global Assessment of Disease Activity – TO BE COMPLETED BY PHYSICIAN
Date of Birth: _
The SLEDAI scores were consistent and using its correlation to the SELENA SLEDAI modification.
Patient ID:
Questions
Value Coefficient
Patient Global Assessment of Gender: Male Female
Disease Activity (PGA) (cm) Physician Global Assessment of strongly correlated (r=0.791; p<0.001) with the Secondary: To test the usability and the accuracy of an
Please indicate all treatments (medications) you are taking for your Lupus
Disease Activity (PHGA) (cm) Value Score for positive response Total Score (2)
mg/day 0 7.5 mg/day -> 0
LAST scores at the baseline and follow-up 7.6 10 mg/day->1
electronic application of the same tool.
10.1 15 mg/day->2
Laboratory Test Results
15.1 20 mg/day -> 4
Greater than 20.1 mg/day->5

Questions
Value Algorithm
2. Mycophenolate Mofetil Formula, subscore = (value – 0.83)/0.83 * 100 mg/day 5, if positive response for any
or all of questions 3-5 50.1 75% -> 8 METHODS AND PATIENTS 75.1 100 %-> 10 6. Intravenous(IV) Steroids Formula, subscore = (value – 0.15)/0.15 * 100 7. Cyclophosphamide 9. Hydroxychloroquine mg/day N/A
50.1 75% -> 8 75.1 100% -> 10 Total Score (1)
Anti-dsDNA (unit/mL) Note: Maximum score is 20 This multicenter study was initiated in four Canadian
50.1 100 -> 8 Considering all the ways your SLE affects you, please mark a vertical line on the scale below for how you are
> 100 -> 10 Total Score (3)
feeling this week.
clinics: two in Newfoundland and two in Ontario. The LAST
GRAPH 2: An example of C-Last & LAST disease activity
Very good,
Very poor,
TABLE 1: Demographics and other Characteristics of Patients with SLE
no symptoms
severe symptoms
Total Score = Total Score (1) Total Score (2) Total Score (3) =
tracking plot over patient's multiple visits
included patient global assessment of disease activity

Physician Global Assessment of Disease Activity (cm)
Dr. Majed Khraishi
(PGA), physician global assessment of disease activity
Age, mean (SD)
45.9 (14.7)
NEXUS Clinical Research/NL Research
(PHGA), C3, C4 and Anti-ds Anti-DNA titer abnormalities,
Gender, Females (n %)
28 (90.3%)
CLINICAL LUPUS ACTIVITY SCORING TOOL (C-LAST) CLINICAL LUPUS ACTIVITY SCORING TOOL (C-LAST) and a formula incorporating the current immunomodulating
Patient Name: _
Date of Birth:
Physician Global Assessment of Disease Activity (cm) medication used as an indication of SLE activity. Patients
Duration of SLE, mean (SD)
14.2 (6.0)
Patient ID:
Gender: Male Female
who met the SLE ACR 1997 criteria update were recruited
Please indicate all treatments (medications) you are taking for your Lupus
LAST Score, mean (SD)
34.5 (17.8)
Score for positive response Global Assessment of Disease Activity – TO BE COMPLETED BY PHYSICIAN
0 7.5 mg/day -> 0 7.6 10 mg/day->1 and evaluated in the study centres using LAST. Some of the
10.1 15 mg/day->2 Questions
Value Coefficient
15.1 20 mg/day -> 4 Patient Global Assessment of Greater than 20.1 mg/day->5 Disease Activity (cm) Physician Global Assessment of 2. Mycophenolate Mofetil Disease Activity (cm) patients were prospectively followed and evaluated by the
SS Score, mean (SD)
6.6 (3.5)
Total Score (2)
5, if positive response for any or all of questions 3-5 same tool at each visit. The SS was also calculated for each
Total Score = Total Score (1) Total Score (2) = _
6. Intravenous(IV) Steroids NLRT Website
visit. Descriptive statistics and correlation bivariates were
7. Cyclophosphamide 9. Hydroxychloroquine conducted. The LAST scores of the disease activity of
Total Score (1)
Note: Maximum score is 20 patients with multiple assessments were compared to the
Considering all the ways your SLE affects you, please mark a vertical line on the scale below for how you are
¹ Khraishi, Majed, Aslanov, Rana, Fudge, Krista.
feeling this week.
The Validation of a New Simple Disease Activity Tool in Systemic Lupus Erythematosus (SLE): The Lupus
Very good,
Very poor,
SS scores.
DISCLOSURE: Dr. Khraishi received a research grant from UCB Canada.
no symptoms
severe symptoms
Activity Scoring Tool (LAST) As Compared to the Sledai Selena Modification. Arthritis & Rheumatism,
Volume 64, ACR 2012 Washington, DC. Nov 9-14, 2012
Poster Design & Printing by Genigraphics® - 800.790.4001

Source: http://www.nlrt.ca/Multicentre%20LAST%20Study%20v3.pdf

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