Consensus treatment plans for induction therapy of newly diagnosed proliferative lupus nephritis in juvenile systemic lupus erythematosus

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 & 22 others 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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Abstract

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.

Original languageEnglish (US)
Pages (from-to)375-383
Number of pages9
JournalArthritis Care and Research
Volume64
Issue number3
DOIs
StatePublished - Mar 2012

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Lupus Nephritis
Systemic Lupus Erythematosus
Therapeutics
Rheumatology
Pediatrics
Mycophenolic Acid
Immunosuppressive Agents
North America

ASJC Scopus subject areas

  • Rheumatology

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Consensus treatment plans for induction therapy of newly diagnosed proliferative lupus nephritis in juvenile systemic lupus erythematosus. / Mina, Rina; Von Scheven, Emily; Ardoin, Stacy P.; Eberhard, B. Anne; Punaro, Marilynn; Ilowite, Norman; Hsu, Joyce; Klein-Gitelman, Marisa; Moorthy, L. Nandini; Muscal, Eyal; Radhakrishna, Suhas M.; Wagner-Weiner, Linda; Adams, Matthew; Blier, Peter; Buckley, Lenore; Chalom, Elizabeth; Chédeville, Gaëlle; Eichenfield, Andrew; Fish, Natalya; Henrickson, Michael; Hersh, Aimee O.; Hollister, Roger; Jones, Olcay; Jung, Lawrence; Levy, Deborah; Lopez-Benitez, Jorge; McCurdy, Deborah; Miettunen, Paivi M.; Quintero-Del Rio, Ana I.; Rothman, Deborah; Rullo, Ornella; Ruth, Natasha; Schanberg, Laura E.; Silverman, Earl; Singer, Nora G.; Soep, Jennifer; Syed, Reema; Vogler, Larry B.; Yalcindag, Ali; Yildirim-Toruner, Cagri; Wallace, Carol A.; Brunner, Hermine I.

In: Arthritis Care and Research, Vol. 64, No. 3, 03.2012, p. 375-383.

Research output: Contribution to journalArticle

Mina, R, Von Scheven, E, Ardoin, SP, Eberhard, BA, Punaro, M, Ilowite, N, Hsu, J, Klein-Gitelman, M, Moorthy, LN, Muscal, E, Radhakrishna, SM, Wagner-Weiner, L, Adams, M, Blier, P, Buckley, L, Chalom, E, Chédeville, G, Eichenfield, A, Fish, N, Henrickson, M, Hersh, AO, Hollister, R, Jones, O, Jung, L, Levy, D, Lopez-Benitez, J, McCurdy, D, Miettunen, PM, Quintero-Del Rio, AI, Rothman, D, Rullo, O, Ruth, N, Schanberg, LE, Silverman, E, Singer, NG, Soep, J, Syed, R, Vogler, LB, Yalcindag, A, Yildirim-Toruner, C, Wallace, CA & Brunner, HI 2012, 'Consensus treatment plans for induction therapy of newly diagnosed proliferative lupus nephritis in juvenile systemic lupus erythematosus', Arthritis Care and Research, vol. 64, no. 3, pp. 375-383. https://doi.org/10.1002/acr.21558
Mina, Rina ; Von Scheven, Emily ; Ardoin, Stacy P. ; Eberhard, B. Anne ; Punaro, Marilynn ; Ilowite, Norman ; Hsu, Joyce ; Klein-Gitelman, Marisa ; Moorthy, L. Nandini ; Muscal, Eyal ; Radhakrishna, Suhas M. ; Wagner-Weiner, Linda ; Adams, Matthew ; Blier, Peter ; Buckley, Lenore ; Chalom, Elizabeth ; Chédeville, Gaëlle ; Eichenfield, Andrew ; Fish, Natalya ; Henrickson, Michael ; Hersh, Aimee O. ; Hollister, Roger ; Jones, Olcay ; Jung, Lawrence ; Levy, Deborah ; Lopez-Benitez, Jorge ; McCurdy, Deborah ; Miettunen, Paivi M. ; Quintero-Del Rio, Ana I. ; Rothman, Deborah ; Rullo, Ornella ; Ruth, Natasha ; Schanberg, Laura E. ; Silverman, Earl ; Singer, Nora G. ; Soep, Jennifer ; Syed, Reema ; Vogler, Larry B. ; Yalcindag, Ali ; Yildirim-Toruner, Cagri ; Wallace, Carol A. ; Brunner, Hermine I. / Consensus treatment plans for induction therapy of newly diagnosed proliferative lupus nephritis in juvenile systemic lupus erythematosus. In: Arthritis Care and Research. 2012 ; Vol. 64, No. 3. pp. 375-383.
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abstract = "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.",
author = "Rina Mina and {Von Scheven}, Emily and Ardoin, {Stacy P.} and Eberhard, {B. Anne} and Marilynn Punaro and Norman Ilowite and Joyce Hsu and Marisa Klein-Gitelman and Moorthy, {L. Nandini} and Eyal Muscal and Radhakrishna, {Suhas M.} and Linda Wagner-Weiner and Matthew Adams and Peter Blier and Lenore Buckley and Elizabeth Chalom and Ga{\"e}lle Ch{\'e}deville and Andrew Eichenfield and Natalya Fish and Michael Henrickson and Hersh, {Aimee O.} and Roger Hollister and Olcay Jones and Lawrence Jung and Deborah Levy and Jorge Lopez-Benitez and Deborah McCurdy and Miettunen, {Paivi M.} and {Quintero-Del Rio}, {Ana I.} and Deborah Rothman and Ornella Rullo and Natasha Ruth and Schanberg, {Laura E.} and Earl Silverman and Singer, {Nora G.} and Jennifer Soep and Reema Syed and Vogler, {Larry B.} and Ali Yalcindag and Cagri Yildirim-Toruner and Wallace, {Carol A.} and Brunner, {Hermine I.}",
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T1 - Consensus treatment plans for induction therapy of newly diagnosed proliferative lupus nephritis in juvenile systemic lupus erythematosus

AU - Mina, Rina

AU - Von Scheven, Emily

AU - Ardoin, Stacy P.

AU - Eberhard, B. Anne

AU - Punaro, Marilynn

AU - Ilowite, Norman

AU - Hsu, Joyce

AU - Klein-Gitelman, Marisa

AU - Moorthy, L. Nandini

AU - Muscal, Eyal

AU - Radhakrishna, Suhas M.

AU - Wagner-Weiner, Linda

AU - Adams, Matthew

AU - Blier, Peter

AU - Buckley, Lenore

AU - Chalom, Elizabeth

AU - Chédeville, Gaëlle

AU - Eichenfield, Andrew

AU - Fish, Natalya

AU - Henrickson, Michael

AU - Hersh, Aimee O.

AU - Hollister, Roger

AU - Jones, Olcay

AU - Jung, Lawrence

AU - Levy, Deborah

AU - Lopez-Benitez, Jorge

AU - McCurdy, Deborah

AU - Miettunen, Paivi M.

AU - Quintero-Del Rio, Ana I.

AU - Rothman, Deborah

AU - Rullo, Ornella

AU - Ruth, Natasha

AU - Schanberg, Laura E.

AU - Silverman, Earl

AU - Singer, Nora G.

AU - Soep, Jennifer

AU - Syed, Reema

AU - Vogler, Larry B.

AU - Yalcindag, Ali

AU - Yildirim-Toruner, Cagri

AU - Wallace, Carol A.

AU - Brunner, Hermine I.

PY - 2012/3

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N2 - 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.

AB - 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.

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