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

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

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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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 languageEnglish
Article number110214
JournalClinical Immunology
Volume263
DOIs
Publication statusPublished - Jun 2024

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