Challenges and perspectives in clinical assessment of systemic autoimmune rheumatic diseases

Abstract

Systemic autoimmune rheumatic diseases including systemic lupus erythematous（SLE）are diseases of unknown cause, in which a diverse population is formed without a gold standard for each disease. Therefore, only classification criteria（for a patient group）have been created and revised, and international diagnostic criteria（for individual patient）cannot be proposed. The treatment strategy is not directly determined by the disease diagnosis, but by the severity of the disease. Severity, in turn, is determined by the prediction of poor prognosis in a relatively short term, namely the current degree of organ damage, the current activity of organ damage, the contribution of the affected organ to life and vital function, and the treatment responsiveness. It is easy to understand if activity is defined as the progression speed（time differential value）of organ damage. Although clinical evaluations currently in widespread use meet certain criteria, it is expected that they will be complemented and improved by the use of new imaging tests, biomarkers, and artificial intelligence in the future.