Development of the CLASI as a Tool to Measure Disease Severity and Responsiveness to Therapy in Cutaneous Lupus Erythematosus

Klein, Rachel S.; Moghadam-Kia, Siamak; LoMonico, Jonathan; Okawa, Joyce; Coley, Christopher M.; Taylor, Lynne; Troxel, Andrea B.; Werth, Victoria P.

doi:10.1001/archdermatol.2010.435

Cited by 158 publications

(163 citation statements)

References 9 publications

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“…When we recalculated the median (range) CLASI activity score of all 11 patients, it changed from 6.0 (0-12) to 5.0 (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11). Response to antimalarials in 36 patients with lupus erythematosus tumidus was reported recently.…”

Section: Discussionmentioning

confidence: 98%

“…The same dermatologist checked the CLASI of all patients. Patients were categorized as responders (improved) or nonresponders (unchanged or worsened) using the criteria of a 4-point or 20% decrease in the CLASI activity score [10]. Joint pain, malaise, and the patient global assessment of SLE in the past month were measured by patient visual analog scale (VAS).…”

Section: Measurement Of Therapeutic Responsementioning

confidence: 99%

“…The content validity, inter-rater validity, intra-rater validity, practical applicability, and clinical responsiveness of the CLASI have been established in previous studies [9,10]. Seven clinical trials (phases I and II) using CLASI are currently running (http://clinicaltrials.…”

Section: Introductionmentioning

confidence: 99%

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Response to hydroxychloroquine in Japanese patients with systemic lupus erythematosus using the cutaneous lupus erythematosus disease area and severity index (CLASI)

Yokogawa¹,

Kato²,

Suzuki³

et al. 2011

Mod Rheumatol

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We evaluated the cutaneous lupus erythematosus disease area and severity index (CLASI) in Japanese patients with systemic lupus erythematosus (SLE) in order to design a clinical trial of hydroxychloroquine (HCQ) in Japan. Our prospective cohort study consisted of seven SLE patients with active skin disease who started HCQ at Tokyo Metropolitan Tama Medical Center. The therapeutic responses were assessed at 4 months. Patients were categorized as responders (improved) or non-responders (unchanged or worsened) using the criteria of a 4-point or 20% decrease in the CLASI activity score. We also assessed joint pain determined by patient visual analog scale (VAS), malaise (VAS), patient global assessment of SLE (VAS), and constitutional and musculoskeletal symptoms according to the British Isles Lupus Assessment Group (BILAG) disease activity index. Six patients (86%) were categorized as responders. The median (range) CLASI activity score of all patients at assessment had changed from 8.0 (2-22) to 4 (2-10). All five patients with joint pain and all five patients with malaise showed improvement in patient VAS but the BILAG findings failed to capture these improvements. In conclusion, the cutaneous aspects of SLE can be measured by the CLASI. The CLASI activity score may be a reasonable primary endpoint when performing a clinical trial of HCQ.

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Section: Discussionmentioning

confidence: 98%

Section: Measurement Of Therapeutic Responsementioning

confidence: 99%

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Response to hydroxychloroquine in Japanese patients with systemic lupus erythematosus using the cutaneous lupus erythematosus disease area and severity index (CLASI)

Yokogawa¹,

Kato²,

Suzuki³

et al. 2011

Mod Rheumatol

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“…Revised criteria were suggested, but still need to be incorporated into studies and clinical practice (16). Besides the physician assessment, disease activity of CLE could be measured by CLASI (17,18). It was revised and improved in 2010 to take the different subtypes of CLE -especially lupus erythemathosus profundus and LET -into account (4).…”

Section: Discussionmentioning

confidence: 99%

Mepacrine in Recalcitrant Cutaneous Lupus Erythematosus: Old-fashioned or Still Useful?

Benoit¹,

Goebeler²

2015

Acta Derm Venerol

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Treatment of recalcitrant cutaneous lupus erythematosus (CLE) is challenging. In situations where conventional treatment approaches fail mepacrine - an antimalarial/antiinflammatory drug that has fallen into oblivion in the last decades - might still be a promising option. We retrospectively analysed medical records of 10 patients with refractory CLE that were treated with mepacrine (100-200 mg/day) as mono- or combination therapy for various time intervals between 2001 and 2013 at the University Hospital Würzburg. Mepacrine was generally well tolerated. Side effects were mild and usually resolved after reduction or cessation. Over 50% of the patients experienced amelioration of their symptoms despite a previously recalcitrant clinical course. Altogether, our data demonstrate that mepacrine still remains a useful and effective therapeutic option for other-wise treatment-resistant CLE.

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“…The activity score is based on the erythema, scale, mucous membrane lesions, and nonscarring alopecia. A recent study gives us a foundation for the practical use of the CLASI in clinical trials as a tool to measure disease severity and responsiveness to therapy [2].…”

Section: Introductionmentioning

confidence: 99%

Cutaneous manifestations of systemic lupus erythematosus

2018

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Systemic lupus erythematosus (SLE) is a multiorgan autoimmune disease of unknown etiology with many clinical manifestations. The skin is one of the target organs most variably affected by the disease. The American College of Rheumatology (ACR) established 11 criteria as a classificatory instrument to operationalise the definition of SLE in clinical trials. They were not intended to be used to diagnose individuals and do not do well in that capacity. Cutaneous lesions account for four of these 11 revised criteria of SLE. Skin lesions in patients with lupus may be specific or nonspecific. This paper covers the SLE-specific cutaneous changes: malar rash, discoid rash, photosensitivity, and oral mucosal lesions as well as SLE nonspecific skin manifestations, their pathophysiology, and management. A deeper thorough understanding of the cutaneous manifestations of SLE is essential for diagnosis, prognosis, and efficient management. Thus, dermatologists should cooperate with other specialties to provide optimal care of SLE patient.

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Development of the CLASI as a Tool to Measure Disease Severity and Responsiveness to Therapy in Cutaneous Lupus Erythematosus

Abstract: Objective: To determine how to use the Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) to classify patients according to disease severity (mild, moderate, and severe) and to identify which patients respond to therapy.Design: Cohort.

Cited by 158 publications

References 9 publications

Response to hydroxychloroquine in Japanese patients with systemic lupus erythematosus using the cutaneous lupus erythematosus disease area and severity index (CLASI)

Response to hydroxychloroquine in Japanese patients with systemic lupus erythematosus using the cutaneous lupus erythematosus disease area and severity index (CLASI)

Mepacrine in Recalcitrant Cutaneous Lupus Erythematosus: Old-fashioned or Still Useful?

Cutaneous manifestations of systemic lupus erythematosus

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