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Defining remission in childhood-onset lupus: PReS-endorsed consensus definitions by an international task force.
Smith, E M D; Aggarwal, A; Ainsworth, J; Al-Abadi, E; Avcin, T; Bortey, L; Burnham, J; Ciurtin, C; Hedrich, C M; Kamphuis, S; Lambert, L; Levy, D M; Lewandowski, L; Maxwell, N; Morand, E; Özen, S; Pain, C E; Ravelli, A; Saad Magalhaes, C; Pilkington, C; Schonenberg-Meinema, D; Scott, C; Tullus, K; Beresford, M W.
Affiliation
  • Smith EMD; Department of Women's & Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK; Department of Paediatric Rheumatology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK. Electronic address: esmith8@liverpool.ac.uk.
  • Aggarwal A; Department of Clinical Immunology & Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
  • Ainsworth J; Department of Women's & Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK; Department of Paediatric Rheumatology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK.
  • Al-Abadi E; Department of Paediatric Rheumatology, Birmingham Women's and Children's Hospital NHS Foundation Trust, Birmingham, UK.
  • Avcin T; Department of Allergology, Rheumatology and Clinical Immunology, Children's Hospital, University Medical Center Ljubljana, Slovenia.
  • Bortey L; TARGET Lupus Public Patient Involvement and Engagement Group, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.
  • Burnham J; Department of Pediatric Rheumatology, Children's Hospital of Philadelphia, Philadelphia, USA.
  • Ciurtin C; Centre for Adolescent Rheumatology Versus Arthritis, Division of Medicine, University College London, UK.
  • Hedrich CM; Department of Women's & Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK; Department of Paediatric Rheumatology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK.
  • Kamphuis S; Department of Pediatric Rheumatology, Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, Netherlands.
  • Lambert L; TARGET Lupus Public Patient Involvement and Engagement Group, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.
  • Levy DM; Division of Rheumatology, Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Canada.
  • Lewandowski L; Lupus Genomics and Global Health Disparities Unit, Systemic Autoimmunity Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, USA.
  • Maxwell N; TARGET Lupus Public Patient Involvement and Engagement Group, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.
  • Morand E; Centre for Inflammatory Diseases, Monash University, Melbourne, Australia.
  • Özen S; Department of Pediatrics, Hacettepe University, Ankara, Turkey.
  • Pain CE; Department of Women's & Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK; Department of Paediatric Rheumatology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK.
  • Ravelli A; Direzione Scientifica, IRCCS Istituto Giannina Gaslini, Genoa, Italy; Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno Infantili (DINOGMI), Università degli Studi di Genova, Genoa, Italy.
  • Saad Magalhaes C; Paediatric Rheumatology Division, Botucatu Medical School, Sao Paulo State, University (UNESP), Sao Paulo, Brazil.
  • Pilkington C; Department of Paediatric Rheumatology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
  • Schonenberg-Meinema D; Department of Pediatric Immunology, Rheumatology and Infectious diseases, Emma Children's Hospital, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, the Netherlands.
  • Scott C; Department of Pediatric Rheumatology, University of Cape Town, Cape Town, South Africa.
  • Tullus K; Department of Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
  • Beresford MW; Department of Women's & Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK; Department of Paediatric Rheumatology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK.
Clin Immunol ; 263: 110214, 2024 Jun.
Article in En | MEDLINE | ID: mdl-38604255
ABSTRACT

OBJECTIVE:

To derive childhood-onset SLE (cSLE) specific remission definitions for future treat-to-target (T2T) trials, observational studies, and clinical practice.

METHODS:

The cSLE International T2T Task Force conducted Delphi surveys exploring paediatric perspectives on adult-onset SLE remission targets. A modified nominal group technique was used to discuss, refine, and agree on the cSLE remission target criteria.

RESULTS:

The Task Force proposed two definitions of remission 'cSLE clinical remission on steroids (cCR)' and 'cSLE clinical remission off steroids (cCR-0)'. The common criteria are (1) Clinical-SLEDAI-2 K = 0; (2) PGA score < 0.5 (0-3 scale); (4) stable antimalarials, immunosuppressive, and biologic therapy (changes due to side-effects, adherence, weight, or when building up to target dose allowed). Criterion (3) in cCR is the prednisolone dose ≤0.1 mg/kg/day (maximum 5 mg/day), whereas in cCR-0 it is zero.

CONCLUSIONS:

cSLE definitions of remission have been proposed, maintaining sufficient alignment with the adult-SLE definition to facilitate life-course research.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Remission Induction / Consensus / Lupus Erythematosus, Systemic Limits: Child / Humans Language: En Journal: Clin Immunol Journal subject: ALERGIA E IMUNOLOGIA Year: 2024 Document type: Article
Fulltext
Add to My VHL
Print
XML
PubMed Links
Search on Google

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Remission Induction / Consensus / Lupus Erythematosus, Systemic Limits: Child / Humans Language: En Journal: Clin Immunol Journal subject: ALERGIA E IMUNOLOGIA Year: 2024 Document type: Article