Towards development of treat to target (T2T) in childhood-onset systemic lupus erythematosus: PReS-endorsed overarching principles and points-to-consider from an international task force

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dc.contributor.authorSmith, Eve Mary Dorothy
dc.contributor.authorAggarwal, Amita
dc.contributor.authorAinsworth, Jenny
dc.contributor.authorAl-Abadi, Eslam
dc.contributor.authorAvcin, Tadej
dc.contributor.authorBortey, Lynette
dc.contributor.authorBurnham, Jon
dc.contributor.authorCiurtin, Coziana
dc.contributor.authorHedrich, Christian M
dc.contributor.authorKamphuis, Sylvia
dc.contributor.authorLevy, Deborah M
dc.contributor.authorLewandowski, Laura B
dc.contributor.authorMaxwell, Naomi
dc.contributor.authorMorand, Eric F
dc.contributor.authorOzen, Seza
dc.contributor.authorPain, Clare E
dc.contributor.authorRavelli, Angelo
dc.contributor.authorSaad Magalhaes, Claudia [UNESP]
dc.contributor.authorPilkington, Clarissa A
dc.contributor.authorSchonenberg-Meinema, Dieneke
dc.contributor.authorScott, Christiaan
dc.contributor.authorTullus, Kjell
dc.contributor.authorBeresford, Michael William
dc.contributor.institutionUniversity of Liverpool Faculty of Health and Life Sciences
dc.contributor.institutionAlder Hey Children's Nhs Foundation Trust
dc.contributor.institutionSanjay Gandhi Post Graduate Institute of Medical Sciences
dc.contributor.institutionBirmingham Children's Hospital Nhs Foundation Trust
dc.contributor.institutionDivision of Paediatrics
dc.contributor.institutionThe Children's Hospital of Philadelphia
dc.contributor.institutionUniversity College London
dc.contributor.institutionErasmus Medical Center
dc.contributor.institutionThe Hospital for Sick Children
dc.contributor.institutionUniversity of Toronto
dc.contributor.institutionNational Institute of Arthritis and Musculoskeletal and Skin Diseases Systemic Autoimmunity Branch
dc.contributor.institutionMonash University
dc.contributor.institutionHacettepe University Faculty of Medicine
dc.contributor.institutionIstituto Giannina Gaslini Istituto Pediatrico di Ricovero e Cura A Carattere Scientifico
dc.contributor.institutionUniversità Degli Studi di Genova
dc.contributor.institutionUniversidade Estadual Paulista (UNESP)
dc.contributor.institutionGreat Ormond Street Hospital for Children
dc.contributor.institutionUniversity of Amsterdam
dc.contributor.institutionAmsterdam University Medical Centres
dc.contributor.institutionUniversity of Cape Town
dc.date.accessioned2023-07-29T13:50:17Z
dc.date.available2023-07-29T13:50:17Z
dc.date.issued2023-06-01
dc.description.abstractObjectives Application of 'treat-to-target' (T2T) in childhood-onset systemic lupus erythematosus (cSLE) may improve care and health outcomes. This initiative aimed to harmonise existing evidence and expert opinion regarding T2T for cSLE. Methods An international T2T Task Force was formed of specialists in paediatric rheumatology, paediatric nephrology, adult rheumatology, patient and parent representatives. A steering committee formulated a set of draft overarching principles and points-to-consider, based on evidence from systematic literature review. Two on-line preconsensus meeting Delphi surveys explored healthcare professionals' views on these provisional overarching principles and points-to-consider. A virtual consensus meeting employed a modified nominal group technique to discuss, modify and vote on each overarching principle/point-to-consider. Agreement of >80% of Task Force members was considered consensus. Results The Task Force agreed on four overarching principles and fourteen points-to-consider. It was agreed that both treatment targets and therapeutic strategies should be subject to shared decision making with the patient/caregivers, with full remission the preferred target, and low disease activity acceptable where remission cannot be achieved. Important elements of the points-to-consider included: aiming for prevention of flare and organ damage; glucocorticoid sparing; proactively addressing factors that impact health-related quality of life (fatigue, pain, mental health, educational challenges, medication side effects); and aiming for maintenance of the target over the long-term. An extensive research agenda was also formulated. Conclusions These international, consensus agreed overarching principles and points-to-consider for T2T in cSLE lay the foundation for future T2T approaches in cSLE, endorsed by the Paediatric Rheumatology European Society.en
dc.description.affiliationDepartment of Women's & Children's Health Institute of Life Course and Medical Sciences University of Liverpool Faculty of Health and Life Sciences
dc.description.affiliationDepartment of Paediatric Rheumatology Alder Hey Children's Nhs Foundation Trust
dc.description.affiliationDepartment of Clinical Immunology & Rheumatology Sanjay Gandhi Post Graduate Institute of Medical Sciences, Uttar Pradesh
dc.description.affiliationDepartment of Paediatric Rheumatology Birmingham Children's Hospital Nhs Foundation Trust
dc.description.affiliationDepartment of Pediatric Rheumatology and Clinical Immunology University Medical Centre Ljubljana Division of Paediatrics
dc.description.affiliationTarget Lupus Public Patient Involvement and Engagement Group University of Liverpool Faculty of Health and Life Sciences
dc.description.affiliationDepartment of Pediatric Rheumatology The Children's Hospital of Philadelphia
dc.description.affiliationCentre for Adolescent Rheumatology Versus Arthritis Division of Medicine University College London
dc.description.affiliationDepartment of Paediatric Rheumatology Erasmus Medical Center
dc.description.affiliationDepartment of Pediatric Rheumatology The Hospital for Sick Children
dc.description.affiliationDepartment of Pediatric Rheumatology University of Toronto
dc.description.affiliationNational Institutes of Health National Institute of Arthritis and Musculoskeletal and Skin Diseases Systemic Autoimmunity Branch
dc.description.affiliationDepartment of Rheumatology Monash University
dc.description.affiliationDepartment of Pediatrics Division of Rheumatology Hacettepe University Faculty of Medicine
dc.description.affiliationDirezione Scientifica Istituto Giannina Gaslini Istituto Pediatrico di Ricovero e Cura A Carattere Scientifico, Liguria
dc.description.affiliationDipto. di Neuroscienze Riabilitazione Oftalmologia Genetica e Scienze Materno Infantili (DINIGMI) Università Degli Studi di Genova
dc.description.affiliationDepartment of Pediatric Rheumatology Botucatu Medical School Sao Paulo University Faculty of Medicine
dc.description.affiliationDepartment of Paediatric Rheumatology Great Ormond Street Hospital for Children
dc.description.affiliationDepartment of Pediatric Immunology Rheumatology and Infectious Diseases University of Amsterdam
dc.description.affiliationEmma Children's Hospital Amsterdam University Medical Centres
dc.description.affiliationDepartment of Paediatric Rheumatology University of Cape Town, Western Cape
dc.description.affiliationDepartment of Paediatric Nephrology Great Ormond Street Hospital for Children
dc.description.affiliationUnespDepartment of Pediatric Rheumatology Botucatu Medical School Sao Paulo University Faculty of Medicine
dc.format.extent788-798
dc.identifierhttp://dx.doi.org/10.1136/ard-2022-223328
dc.identifier.citationAnnals of the Rheumatic Diseases, v. 82, n. 6, p. 788-798, 2023.
dc.identifier.doi10.1136/ard-2022-223328
dc.identifier.issn1468-2060
dc.identifier.issn0003-4967
dc.identifier.scopus2-s2.0-85152199008
dc.identifier.urihttp://hdl.handle.net/11449/248668
dc.language.isoeng
dc.relation.ispartofAnnals of the Rheumatic Diseases
dc.sourceScopus
dc.subjectAutoimmune Diseases
dc.subjectGlucocorticoids
dc.subjectHealth services research
dc.subjectLupus Erythematosus, Systemic
dc.subjectOutcome and Process Assessment, Health Care
dc.titleTowards development of treat to target (T2T) in childhood-onset systemic lupus erythematosus: PReS-endorsed overarching principles and points-to-consider from an international task forceen
dc.typeArtigo
unesp.author.orcid0000-0002-8371-7597 0000-0002-8371-7597[1]
unesp.author.orcid0000-0002-2187-5186[2]
unesp.author.orcid0000-0002-1999-6341[4]
unesp.author.orcid0000-0002-8911-4113[8]
unesp.author.orcid0000-0002-9507-3338[14]
unesp.author.orcid0000-0001-9658-0385 0000-0001-9658-0385[17]
unesp.author.orcid0000-0002-5400-9911 0000-0002-5400-9911[23]

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