Therapeutic area · Lupus and autoimmune diseaseUpdated September 28, 2026

EDC for lupus and autoimmune trials

Lupus endpoints are built from several disease activity indices, lab values and steroid doses, combined into responder definitions. Capture records every component as structured data, so SRI-4, BICLA and steroid tapering can be derived and checked.

  • SLEDAI-2K descriptors
  • Labs and steroid doses
  • Components kept for derivation

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SLEDAI-2K · Week 24
Subject 015-0033 · Descriptors present in the last 30 daysDraft

Musculoskeletal and skin descriptors

SLEDMSK
Arthritis (4)Rash (2)Alopecia (2)Mucosal ulcers (2)

Immunology descriptors

SLEDIMM
Low complement (2)Increased DNA binding (2)

Renal descriptors

SLEDREN
Urinary casts (4)Haematuria (4)Proteinuria (4)Pyuria (4)
Weighted total derived in analysis

What matters in lupus trials

  • SLEDAI-2K scores 24 weighted descriptors across organ systems (total 0 to 105). BILAG-2004 grades nine organ systems from A (most active) to E (never involved).
  • The SLE Responder Index (SRI-4) requires a reduction of at least 4 points in SLEDAI-2K, no new BILAG A and no more than one new BILAG B, and no worsening of the physician global assessment.
  • BICLA is a BILAG-based composite responder definition used in several recent trials.
  • Steroid tapering is often part of the endpoint, so daily corticosteroid doses must be recorded precisely.
  • Lupus nephritis trials use renal response criteria built on urine protein-to-creatinine ratio and eGFR.

Study design

Composite endpoints need every component

SRI-4 and BICLA are derived from three or more instruments assessed at the same visit. If any component is missing or recorded inconsistently, the participant cannot be classified as a responder, and non-responder imputation often follows. That makes completeness at the visit level the single most important data quality goal in lupus trials.

Record each SLEDAI-2K descriptor as present or absent rather than a total, each BILAG organ system grade, and the physician global assessment on a defined scale. Then derive totals and responder status in analysis, where the rules are written once. The same principle applies to steroid doses: record dose, frequency and dates on the concomitant medications form, and derive daily prednisone-equivalent dose in analysis.

Other autoimmune conditions

The same approach applies across autoimmune disease: component-based activity indices in Sjögren's disease, vasculitis and myositis, joint counts and composite scores in rheumatoid arthritis. See the ACR response and DAS28 template.

SRI-4 components · Subject 015-0033 · Week 52
CriterionMet
SLEDAI-2K reduction of 4 or more12 to 6
No new BILAG A, at most one new BNone new
Physician global not worse+0.1
Steroid taper per protocol7.5 mg/day
Responder status derived from recorded components

Laboratory data

Complement, anti-dsDNA and urine protein in one lab table

Lupus activity depends on laboratory values as much as clinical signs. Lab tables with analytes as rows and unit, result and reference range columns can be drafted by AI from a lab manual and split by sex and age where the source has them. Range edit checks raise queries at entry.

  • AI-drafted lab tables for review.
  • Reference ranges by sex and age.
  • Range checks with auto-queries.
Lab results eCRF template
Build this form with AI · Lab table
central_lab_ranges.xlsx48 KB
2 tables24 rows1 unrecognised analyte

Haematology

RowCodeUnitRangeStratum
HaemoglobinHGBg/dL13.0-17.0Male 18-65 y
HaemoglobinHGBg/dL12.0-15.5Female 18-65 y
PlateletsPLAT10^9/L150-400All
ALTALTU/L7-56All
Site QC flagSITEQC--All

Build a SLEDAI-2K form and lab table

Set up component-level forms in the free sandbox.

Build your lupus study free

Endpoints

Lupus endpoints and their components

EndpointComponents
SRI-4SLEDAI-2K change, BILAG-2004 new grades, physician global assessment
BICLABILAG-2004 improvement and no worsening, SLEDAI-2K, physician global, no treatment failure
Lupus low disease activity stateSLEDAI-2K, no new activity, physician global, prednisone dose, standard therapy
Complete renal responseUrine protein-to-creatinine ratio, eGFR, rescue therapy
FlareSLEDAI flare index or BILAG-defined flare
Fatigue and quality of lifeFACIT-Fatigue, SF-36, lupus-specific QoL measures

Definitions vary between trials. Write the exact rules in the protocol and analysis plan.

Assessors

Training for complex indices

BILAG-2004 in particular requires training: the grade for each organ system depends on detailed definitions and on whether features are new, worse, the same or improving. Inconsistent grading across sites is a known source of noise in lupus trials. Sponsors usually train assessors before the first participant and review grading patterns centrally during the study.

Fatigue is often what participants care about most. Collecting FACIT-Fatigue at home between visits, alongside clinical indices, gives a fuller picture of treatment effect.

Study build

Lupus study build checklist

Component-level forms

SLEDAI-2K descriptors, BILAG grades and physician global.

Responder rules

SRI-4, BICLA or LLDAS rules in the analysis plan.

Steroid dosing

Dose, frequency and dates for every course.

Lab table

Complement, anti-dsDNA, urinalysis and UPCR with ranges.

Assessor training

BILAG and SLEDAI training before first participant.

Fatigue PRO

Scheduled at home between visits.

FAQ

Questions teams ask before they switch

Something not covered here? Ask us directly.

What is SRI-4?

The SLE Responder Index: a reduction of at least 4 points in SLEDAI-2K, no new BILAG A and no more than one new BILAG B organ score, and no worsening of the physician global assessment.

What is the difference between SLEDAI-2K and BILAG-2004?

SLEDAI-2K scores weighted descriptors into a total. BILAG-2004 grades each of nine organ systems from A to E.

Should the eCRF store the SLEDAI total?

Store each descriptor so the total can be derived and checked. Totals and responder status are derived in analysis.

How are steroid doses handled?

Record dose, frequency and dates on the concomitant medications form, and derive daily prednisone-equivalent dose in analysis.

Can AI draft the lab table?

Yes. AI can draft a lab table from a lab manual or file, for your review. Nothing is saved without review.

Can I try it free?

Yes, in the free sandbox with every feature.

Lupus endpoints you can derive and defend

Every component structured and checked. Free sandbox.

Build your lupus study free