Background
The purpose of this project is to develop a systemic lupus erythematosus (SLE) response index as a standard outcome measure in future therapeutic trials. Currently, there is no widely validated method for defining response to therapy. Most SLE trials to date have failed to meet predesigned endpoints, leading to controversy over whether it is drug treatments or outcome measures that are unsuccessful in SLE. A similar controversy in rheumatoid arthritis (RA) years ago was resolved by examining data from placebo-controlled trials with drugs that were only modestly effective. Important clinical variables were selected, criteria for patient improvement determined, and an index was developed that distinguished treated patients from those getting placebo. This index (ACR 20/50/70) used in RA trials has led to approval of more than 20 drug therapies.