Defining remission in childhood-onset lupus: PReS-endorsed consensus definitions by an international task force

Smith, E.; Aggarwal, A.; Ainsworth, J.; Al-Abadi, E.; Avcin, T.; Bortey, L.; Burnham, J.; Ciurtin, C.; Hedrich, C.; Kamphuis, S.; Lambert, L.; Levy, D.; Lewandowski, L.; Maxwell, N.; Morand, E.; Ozen, S.; Pain, C.; Ravelli, A.; Magalhaes, C.; Pilkington, C.; Schonenberg-Meinema, D.; Scott, C.; Tullus, K.; Beresford, M.

doi:10.1016/j.clim.2024.110214

Defining remission in childhood-onset lupus: PReS-endorsed consensus definitions by an international task force

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Smith E. M. D., Aggarwal A., Ainsworth J., Al-Abadi E., Avcin T., Bortey L., ...More

CLINICAL IMMUNOLOGY, vol.263, 2024 (SCI-Expanded)

Publication Type: Article / Article
Volume: 263
Publication Date: 2024
Doi Number: 10.1016/j.clim.2024.110214
Journal Name: CLINICAL IMMUNOLOGY
Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, Chemical Abstracts Core, EMBASE, MEDLINE, Veterinary Science Database
Hacettepe University Affiliated: Yes

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 sideeffects, 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 adultSLE definition to facilitate life -course research.