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

on behalf of the International cSLE T2T Task Force

doi:10.1016/j.clim.2024.110214

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

on behalf of the International cSLE T2T Task Force

Division of Pediatrics

Department of Women's and Children's Health
University of Liverpool
Department of Paediatric Rheumatology
Alder Hey Children's NHS Foundation Trust
Department of Clinical Immunology & Rheumatology
Sanjay Gandhi Postgraduate Institute of Medical Sciences
Department of Paediatric Rheumatology
Birmingham Women's and Children's NHS Foundation Trust
Department of Allergology
UMC Ljubljana
Target Lupus Public Patient Involvement and Engagement Group
Department of Pediatric Rheumatology
The Children's Hospital of Philadelphia
Centre for Adolescent Rheumatology Versus Arthritis
University College London
Department of Pediatric Rheumatology
Erasmus University Rotterdam
Division of Clinical and Metabolic Genetics
University of Toronto
Lupus Genomics and Global Health Disparities Unit
National Institutes of Health
Monash University
IRCCS Istituto Giannina Gaslini - Genova
Dipartimento di Neuroscienze
University of Genoa
Paediatric Rheumatology Division
Universidade Estadual Paulista Júlio de Mesquita Filho
Department of Paediatric Rheumatology
Great Ormond Street Hospital for Children NHS Foundation Trust
Department of Pediatric Immunology
University of Amsterdam
Department of Pediatric Rheumatology
University of Cape Town
Department of Paediatric Nephrology
Albert Einstein College of Medicine
Health and Life Sciences
Department of Paediatric Nephrology

Research output: Contribution to journal › Article › peer-review

20 Citations (Scopus)

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.

Original language	English
Article number	110214
Journal	Clinical Immunology
Volume	263
DOIs	https://doi.org/10.1016/j.clim.2024.110214
Publication status	Published - Jun 2024

Keywords

Childhood-onset SLE
Remission
T2T
Treat-to-target
cSLE

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10.1016/j.clim.2024.110214

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@article{9c6448ba4a1543e39ef9da558639e081,

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

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: {\textquoteleft}cSLE clinical remission on steroids (cCR){\textquoteright} and {\textquoteleft}cSLE clinical remission off steroids (cCR-0){\textquoteright}. The common criteria are: (1) Clinical-SLEDAI-2 K = 0; (2) PGA score < 0.5 (0{\textendash}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.",

keywords = "Childhood-onset SLE, Remission, T2T, Treat-to-target, cSLE",

author = "\{on behalf of the International cSLE T2T Task Force\} and Smith, \{E. M.D.\} and A. Aggarwal and J. Ainsworth and E. Al-Abadi and T. Avcin and L. Bortey and J. Burnham and C. Ciurtin and Hedrich, \{C. M.\} and S. Kamphuis and L. Lambert and Levy, \{D. M.\} and L. Lewandowski and N. Maxwell and E. Morand and S. {\"O}zen and Pain, \{C. E.\} and A. Ravelli and \{Saad Magalhaes\}, C. and C. Pilkington and D. Schonenberg-Meinema and C. Scott and K. Tullus and Beresford, \{M. W.\} and B. Goilav and N. Goss and L. Oni and Marks, \{S. D.\}",

note = "Publisher Copyright: {\textcopyright} 2024 The Authors",

year = "2024",

month = jun,

doi = "10.1016/j.clim.2024.110214",

language = "English",

volume = "263",

journal = "Clinical Immunology",

issn = "1521-6616",

publisher = "Academic Press Inc.",

}

TY - JOUR

T1 - Defining remission in childhood-onset lupus

T2 - PReS-endorsed consensus definitions by an international task force

AU - on behalf of the International cSLE T2T Task Force

AU - Smith, E. M.D.

AU - Aggarwal, A.

AU - Ainsworth, J.

AU - Al-Abadi, E.

AU - Avcin, T.

AU - Bortey, L.

AU - Burnham, J.

AU - Ciurtin, C.

AU - Hedrich, C. M.

AU - Kamphuis, S.

AU - Lambert, L.

AU - Levy, D. M.

AU - Lewandowski, L.

AU - Maxwell, N.

AU - Morand, E.

AU - Özen, S.

AU - Pain, C. E.

AU - Ravelli, A.

AU - Saad Magalhaes, C.

AU - Pilkington, C.

AU - Schonenberg-Meinema, D.

AU - Scott, C.

AU - Tullus, K.

AU - Beresford, M. W.

AU - Goilav, B.

AU - Goss, N.

AU - Oni, L.

AU - Marks, S. D.

PY - 2024/6

Y1 - 2024/6

N2 - 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.

AB - 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.

KW - Childhood-onset SLE

KW - Remission

KW - T2T

KW - Treat-to-target

KW - cSLE

UR - https://www.scopus.com/pages/publications/85191445420

U2 - 10.1016/j.clim.2024.110214

DO - 10.1016/j.clim.2024.110214

M3 - Article

C2 - 38604255

AN - SCOPUS:85191445420

SN - 1521-6616

VL - 263

JO - Clinical Immunology

JF - Clinical Immunology

M1 - 110214

ER -

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

Abstract

Keywords

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