Document Detail


Consensus treatment plans for induction therapy of newly diagnosed proliferative lupus nephritis in juvenile systemic lupus erythematosus.
MedLine Citation:
PMID:  22162255     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To formulate consensus treatment plans (CTPs) for induction therapy of newly diagnosed proliferative lupus nephritis (LN) in juvenile systemic lupus erythematosus (SLE).
METHODS: A structured consensus formation process was employed by the members of the Childhood Arthritis and Rheumatology Research Alliance after considering the existing medical evidence and current treatment approaches.
RESULTS: After an initial Delphi survey (response rate = 70%), a 2-day consensus conference, and 2 followup Delphi surveys (response rates = 63-79%), consensus was achieved for a limited set of CTPs addressing the induction therapy of proliferative LN. These CTPs were developed for prototypical patients defined by eligibility characteristics, and included immunosuppressive therapy with either mycophenolic acid orally twice per day, or intravenous cyclophosphamide once per month at standardized dosages for 6 months. Additionally, the CTPs describe 3 options for standardized use of glucocorticoids, including a primarily oral, a mixed oral/intravenous, and a primarily intravenous regimen. There was consensus on measures of effectiveness and safety of the CTPs. The CTPs were well accepted by the pediatric rheumatology providers treating children with LN, and up to 300 children per year in North America are expected to be candidates for the treatment with the CTPs.
CONCLUSION: CTPs for induction therapy of proliferative LN in juvenile SLE based on the available scientific evidence and pediatric rheumatology group experience have been developed. Consistent use of the CTPs may improve the prognosis of proliferative LN, and support the conduct of comparative effectiveness studies aimed at optimizing therapeutic strategies for proliferative LN in juvenile SLE.
Authors:
Rina Mina; Emily von Scheven; Stacy P Ardoin; B Anne Eberhard; Marilynn Punaro; Norman Ilowite; Joyce Hsu; Marisa Klein-Gitelman; L Nandini Moorthy; Eyal Muscal; Suhas M Radhakrishna; Linda Wagner-Weiner; Matthew Adams; Peter Blier; Lenore Buckley; Elizabeth Chalom; Gaëlle Chédeville; Andrew Eichenfield; Natalya Fish; Michael Henrickson; Aimee O Hersh; Roger Hollister; Olcay Jones; Lawrence Jung; Deborah Levy; Jorge Lopez-Benitez; Deborah McCurdy; Paivi M Miettunen; Ana I Quintero-del Rio; Deborah Rothman; Ornella Rullo; Natasha Ruth; Laura E Schanberg; Earl Silverman; Nora G Singer; Jennifer Soep; Reema Syed; Larry B Vogler; Ali Yalcindag; Cagri Yildirim-Toruner; Carol A Wallace; Hermine I Brunner;
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Publication Detail:
Type:  Consensus Development Conference; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Arthritis care & research     Volume:  64     ISSN:  2151-4658     ISO Abbreviation:  Arthritis Care Res (Hoboken)     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-02-29     Completed Date:  2012-07-19     Revised Date:  2014-04-08    
Medline Journal Info:
Nlm Unique ID:  101518086     Medline TA:  Arthritis Care Res (Hoboken)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  375-83     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 by the American College of Rheumatology.
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MeSH Terms
Descriptor/Qualifier:
Child
Humans
Immunosuppressive Agents / therapeutic use*
Lupus Erythematosus, Systemic / drug therapy*
Lupus Nephritis / diagnosis,  drug therapy*
Male
Remission Induction / methods*
Grant Support
ID/Acronym/Agency:
1U01AR059509/AR/NIAMS NIH HHS; C1AR058605-01/AR/NIAMS NIH HHS; K23AR053202/AR/NIAMS NIH HHS; N01-AR-2-2265/AR/NIAMS NIH HHS; P60 AR47784/AR/NIAMS NIH HHS; R13-AR053058-04/AR/NIAMS NIH HHS; RC1 AR058605-01/AR/NIAMS NIH HHS; RC1 AR058605-02/AR/NIAMS NIH HHS; RC2-AR-058934/AR/NIAMS NIH HHS; U01AR055054/AR/NIAMS NIH HHS; UL1 TR000077/TR/NCATS NIH HHS; UL1 TR000423/TR/NCATS NIH HHS
Chemical
Reg. No./Substance:
0/Immunosuppressive Agents
Comments/Corrections

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