American College of Rheumatology Provisional Criteria for Clinically Relevant Improvement in Children and Adolescents With Childhood‐Onset Systemic Lupus Erythematosus

Brunner, Hermine I. ; Holland, Michael J. ; Beresford, Michael W. ; Ardoin, Stacy P. ; Appenzeller, Simone ; Silva, Clovis A. ; Flores, Francisco ; Goilav, Beatrice ; Avar Aydin, Pinar Ozge ; Wenderfer, Scott E. ; Levy, Deborah M. ; Ravelli, Angelo ; Khubchandani, Raju ; Avcin, Tadej ; Klein‐Gitelman, Marisa S. ; Ruperto, Nicolino ; Feldman, Brian M. ; Ying, Jun ; Battagliotti, Cristina ; Brusco, Maria Isabel ; Cuttica, Rubén ; De Cunto, Carmen ; Espada, Graciela ; Farfan, Maximiliano ; Garay, Stella ; Marcantoni, Maria ; Marcela, Alvarez ; Meiorin, Silvia ; Rama, Maria Elena ; Russo, Ricardo ; Torre Walsh, Carolina ; Zamparo, Celso ; Adib, Navid ; Akikusa, Jonathan ; Boros, Christina ; Lee, Senq J. ; Mckay, Damien ; Piper, Susan ; Joos, Rik ; Bica, Blanca ; Campos, Leonardo ; Cavalcanti, André ; do Prado, Rogerio ; Donner‐Maliki, Amanda ; Fernandes, Taciana ; Fonseca, Adriana ; Gasparello de Almeida, Rozana ; Guariento, Andressa ; Gusman, Catherine ; Jusan Fiorot, Fernanda ; Knupp Oliveira, Sheila ; Len, Claudio ; Arruda Campos, Lucia M. ; Machado, Sandra ; Marques, Luciana ; Martins de Carvalho, Luciana ; Moulin, Rodrigo ; Pedroso, Soraya ; Pileggi, Gecilmara ; Romanelli, Paulo Roberto S. ; Saad‐Magalhaes, Claudia ; Sakamoto, Ana ; Santos, Maria Carolina ; Silva, Marco Felipe ; Spelling, Paulo ; Sztajnbok, Slavio ; Terreri, Maria ; Cabral, David ; Chédeville, Gaëlle ; Ellsworth, Janet ; Huber, Adam ; Tucker, Lori ; Houghton, Kristin ; Borzutzky, Arturo ; Ladino, Mabel ; Norambuena, Ximena ; Eraso, Ruth ; Mosquera, Angela ; Velasquez, Monica ; Harjacek, Miroslav ; Jelusic, Marija ; Coto Hermosilla, Cecilia ; Dolezalova, Pavla ; Nielsen, Susan ; Tineo, Carmen ; Alegria, Mauricio ; Dressler, Frank ; Foell, Dirk ; Ganser, Gerd ; Hinze, Claas ; Hufnagel, Markus ; Lutz, Thomas ; Trauzeddel, Ralf ; Boiu, Sorina ; Trachana, Maria ; Tsitsami, Elena ; Cifuentes, Mayra ; Orbán, Ilonka ; Aggarwal, Amita ; Sawhney, Sujata ; Butbul Aviel, Yonatan ; Cimaz, Rolando ; Maggio, Maria Cristina ; Rumba‐Rozenfelde, Ingrid ; Hashad, Soad ; Lim, Sern Chin ; Abud, Carlos ; Burgos‐Vargas, Ruben ; Carreño‐Manjarrez, Roberto ; Enciso Pelaez, Sandra ; Hernandez‐Huirache, Hayde ; Maldonado Velázquez, Rocio ; Orozco, Javier ; Rodriguez‐Lozano, Ana Luisa ; Rojas Pacheco, Omar Ernesto ; Suárez Larios, Luz Maria ; Vega, Gabriel ; Ramírez Miramontes, Julia Verónica ; Ruíz Lopez, Ivon Karina ; Kamphuis, Sylvia ; Schonenberg‐Meinema, Dieneke ; Concannon, Anthony ; Yan, Jaqueline ; Jarquin Jaime, Martha ; Al Abrawi, Safiya ; Vega, Cynthia ; Lopez‐Benitez, Jorge ; Ibáñez Estrella, Amparo ; Miraval, Tatiana ; Dans, Leonia ; Kimseng, Karen Joy ; Opoka‐Winiarska, Violetta ; Rutkowska‐Sak, Lidia ; Smolewska, Elzbieta ; Conde, Marta ; Guedes, Margarida ; del Valle, Enid ; Quintero‐Del Rio, Ana ; Ailioaie, Constantin ; Sparchez, Mihaela ; Alekseeva, Ekaterina ; Keltsev, Vladimir ; Al‐Mayouf, Sulaiman ; Asiri, Abdurhman ; Suwairi, Wafaa ; Susic, Gordana ; Vijatov‐Djuric, Gordana ; Ang, Elizabeth ; Arkachaisri, Thaschawee ; Boteanu, Alina‐Lucica ; Lopez‐Robledillo, Juan Carlos ; Medrano San Ildefonso, Marta ; Modesto, Consuelo ; Calvo, Inmaculada ; Sotoca‐Fernandez, Jorge ; Bolt, Isabel ; Vilaiyuk, Soamarat ; Al‐Abadi, Eslam ; Baildam, Eileen ; Fotis, Lampros ; Pain, Clare ; Pilkington, Clarissa ; Abulaban, Khalid ; Barbar‐Smiley, Fatima ; Binstadt, Bryce ; Bohnsack, John ; Boneparth, Alexis ; Brown, Diane ; Chira, Peter ; Cron, Randy ; Dedeoglu, Fatma ; Eberhard, Anne ; Gedalia, Abraham ; Grom, Alexei ; Henrickson, Michael ; Hom, Christine ; Huggins, Jennifer ; Jerath, Rita ; Jones, Jordan ; Jung, Lawrence ; Kingsbury, Daniel ; Lai, Jamie ; Lovell, Daniel ; Nanda, Kabita ; Nocton, James ; Olson, Judyann ; O’Neil, Kathleen ; Onel, Karen ; Punaro, Lynn ; Reiff, Andreas ; Rouster‐Stevens, Kelly ; Ruth, Natasha ; Schikler, Ken ; Murphy Schmidt, Kara ; Schulert, Grant ; Shaham, Bracha ; Singer, Nora ; Smith, Judith ; Sundel, Robert ; Syverson, Grant ; Vega‐Fernandez, Patricia ; Vehe, Richard ; Wagner‐Weiner, Linda ; Cameto, Juan ; Jurado, Rosario ; Maldonado, Irama (2019) American College of Rheumatology Provisional Criteria for Clinically Relevant Improvement in Children and Adolescents With Childhood‐Onset Systemic Lupus Erythematosus Arthritis Care & Research, 71 (5). pp. 579-590. ISSN 2151-464X

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Official URL: http://doi.org/10.1002/acr.23834

Related URL: http://dx.doi.org/10.1002/acr.23834

Abstract

Objective: To develop a Childhood Lupus Improvement Index (CHILI) as a tool to measure response to therapy in childhood-onset systemic lupus erythematosus (cSLE), with a focus on clinically relevant improvement (CRIc SLE ). Methods: Pediatric nephrology and rheumatology subspecialists (n = 213) experienced in cSLE management were invited to define CRIc SLE and rate a total of 433 unique patient profiles for the presence/absence of CRIc SLE . Patient profiles included the following cSLE core response variables (CRVs): global assessment of patient well-being (patient-global), physician assessment of cSLE activity (MD-global), disease activity index score (here, we used the Systemic Lupus Erythematosus Disease Activity Index), urine protein-to-creatinine ratio, and Child Health Questionnaire physical summary score. Percentage and absolute changes in these cSLE-CRVs (baseline versus follow-up) were considered in order to develop candidate algorithms and validate their performance (sensitivity, specificity, area under the receiver operating characteristic curve [AUC]; range 0-1). Results: During an international consensus conference, unanimous agreement on a definition of CRIc SLE was achieved; cSLE experts (n = 13) concurred (100%) that the preferred CHILI algorithm considers absolute changes in the cSLE-CRVs. After transformation to a range of 0-100, a CHILI score of ≥54 had outstanding accuracy for identifying CRIc SLE (AUC 0.93, sensitivity 81.1%, and specificity 84.2%). CHILI scores also reflect minor, moderate, and major improvement for values exceeding 15, 68, and 92, respectively (all AUC ≥0.92, sensitivity ≥93.1%, and specificity ≥73.4%). Conclusion: The CHILI is a new, seemingly highly accurate index for measuring CRI in cSLE over time. This index is useful to categorize the degree of response to therapy in children and adolescents with cSLE.

Item Type:Article
Source:Copyright of this article belongs to John Wiley & Sons, Inc.
Keywords:lupus, childhood-onset SLE, SLE, pediatric SLE, juvenile SLE, improvement, criteria, children, cSLE
ID Code:129324
Deposited On:22 Nov 2022 11:43
Last Modified:22 Nov 2022 11:43

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