Lupus Low Disease Activity State Checker


Lupus Low Disease Activity State (LLDAS)

Is your patient with SLE in a low disease activity state?

Step 1: SLEDAI 2K

Recent onset. Exclude metabolic, infectious or drug cause

This field is required

Altered ability to function in normal activity due to severe disturbance in the perception of reality. Include hallucinations, incoherence, marked loose assoications, impoverished thought content, marked illogical thinking, bizarre disorganised or catatonic behaviour. Excluded uraemia and drug causes.

This field is required
Organic brain syndrome

Altered mental function with impared orientation, memory or other intelligent function, with rapid onset fluctuating clinical features. Include clouding of consciousness with reduced capacity to focus, and inability to sustain attention to environment, plus at least two of the following: perceptual disturbance, incoherent speech, insomnia or daytime drowsiness, or increased or decreased psychomoto activity. Exclude metabolic, infectious or drug causes.

This field is required
Visual disturbance

Retinal changes of SLE include cytoid bodies, retinal haemorrhages, serous exudate or haemorrhages in the choroids or optic neuritis. Exclude hypertension, infection or drug causes.

This field is required
Cranial nerve disorder

New onset of sensory or motor neuropathy involving cranial nerves.

This field is required
Lupus headache

Severe persistent headache: may be migrainous, but must be nonresponsive to narcotic analgesia.

This field is required

New onset of cerebrovascular accident(s). Exclude arteriosclerosis.

This field is required

Ulceration, gangrene, tender finger nodules, periungual infarction, splinter haemorrhages, or biopsy/angiogram proof of vasculitis.

This field is required

More than 2 joints with pain and signs of inflammation (i.e. tenderness, swelling or effusion).

This field is required

Proximal muscle aching/weakness, associated with elevated creatine phosphokinase/adolase or electromyogram changes or a biopsy showing myositis.

This field is required
Urinary casts

Haem-granular or red blood cell casts.

This field is required

More than 5 red blood cells/high power field. Exclude stone, infection or other cause.

This field is required

More than 0.5g/24 hours. New onset or recent increase of more than 0.5g/24 hours

This field is required

More than 5 white blood cells/high power field. Exclude infection.

This field is required
New rash

New onset or recurrence of inflammatory type rash.

This field is required

New onset or recurrence of abnormal, patchy or diffuse loss of hair.

This field is required
Mucosal ulcers

New onset or recurrence of oral or nasal ulcerations.

This field is required

Pleuritic chest pain with pleural rub or effusion or pleural thickening.

This field is required

Pericardial pain with at least 1 of the following: rub, effusion or electrocardiogram confirmation.

This field is required
Low complement

Decrease in CH50, C3 or C4 below the lower limit of normal for testing laboratory.

This field is required
Increased DNA binding

More than 25% binding by Farr assay or above normal range of testing laboratory.

This field is required

More than 38℃. Exclude infectious cause.

This field is required

Less than 100,000 platelets/mm^3

This field is required

Less than 3000 white blood cell/mm^3. Exclude drug causes.

This field is required
Step 2: New features

Are there any new features of lupus disease activity compared with the previous assessment?

This field is required
Step 3: Physician Global Assessment

Physician global assesment of current lupus disease activity


Type your input data here

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Step 4: Corticosteroids

Not currently requiring prednisolone (or equivalent) OR currently taking prednisolone (or equivalent) dose ≤7.5 mg daily?

This field is required
Step 5: Maintenance theapies

Not currently requiring OR taking well tolerated standard maintenance doses of immunosuppressive drugs and approved biological agents?

This field is required


The tool is for educational use only, is not meant to be a substitute for professional advice and should not be used for medical diagnosis and/or medical treatment.


Golder V, Kandane-Rathnayake R, Huq M, Nim HT, Louthrenoo W, Luo SF, Wu YJ, Lateef A, Sockalingam S, Navarra SV, Zamora L. Lupus low disease activity state as a treatment endpoint for systemic lupus erythematosus: a prospective validation study. The Lancet Rheumatology. 2019 Oct 1;1(2):e95-102.

Franklyn K, Lau CS, Navarra SV, Louthrenoo W, Lateef A, Hamijoyo L, Wahono CS, Chen SL, Jin O, Morton S, Hoi A, Huq M, Nikpour M, Morand EF; Asia-Pacific Lupus Collaboration. Definition and initial validation of a Lupus Low Disease Activity State (LLDAS). Ann Rheum Dis. 2016 Sep;75(9):1615-21. doi: 10.1136/annrheumdis-2015-207726. Epub 2015 Oct 12. PMID: 26458737.

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