OBJECTIVES: Treat-to-target recommendations have identified 'remission' as a target
in systemic lupus erythematosus (SLE), but recognise that there is no universally
accepted definition for this. Therefore, we initiated a process to achieve consensus
on potential definitions for remission in SLE. METHODS: An international task force
of 60 specialists and patient representatives participated in preparatory exercises,
a face-to-face meeting and follow-up electronic voting. The level for agreement was
set at 90%. RESULTS: The task force agreed on eight key statements regarding remission
in SLE and three principles to guide the further development of remission definitions:1.
Definitions of remission will be worded as follows: remission in SLE is a durable
state characterised by ...................... (reference to symptoms, signs, routine
labs).2. For defining remission, a validated index must be used, for example, clinical
systemic lupus erythematosus disease activity index (SLEDAI)=0, British Isles lupus
assessment group (BILAG) 2004 D/E only, clinical European consensus lupus outcome
measure (ECLAM)=0; with routine laboratory assessments included, and supplemented
with physician's global assessment.3. Distinction is made between remission off and
on therapy: remission off therapy requires the patient to be on no other treatment
for SLE than maintenance antimalarials; and remission on therapy allows patients to
be on stable maintenance antimalarials, low-dose corticosteroids (prednisone
