Abstract
Capturing disease activity in SLE remains challenging. The binary nature of global score indices such as the SLEDAI 2000 (SLEDAI-2K) poses limitations, while the complexity of the BILAG-2004 index requires training and more time investment. Recent efforts to improve SLE activity indices include the SLE Disease Activity Score (SLE-DAS) and Easy-BILAG system. This review analyses the main indices used to assess SLE activity, examines their progressive refinements, evaluates their advantages and limitations and aims to identify the optimal index. The SLE-DAS offers greater sensitivity than the SLEDAI-2K and the Easy-BILAG simplifies scoring while maintaining the comprehensiveness of the BILAG-2004. Composite indices like the SLE Responder Index and BILAG-based Composite Lupus Assessment integrate the SLEDAI-2K and BILAG-2004 but are mainly used in clinical trials due to their complexity. This review emphasizes the importance of balancing sensitivity, specificity, simplicity and comprehensiveness in lupus activity measurement. The search for the optimal index remains ongoing.