TY - JOUR
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.
N1 - Copyright:
Copyright 2012 Elsevier B.V., All rights reserved.
PY - 2012/3
Y1 - 2012/3
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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U2 - 10.1002/acr.21558
DO - 10.1002/acr.21558
M3 - Article
C2 - 22162255
AN - SCOPUS:84859824109
VL - 64
SP - 375
EP - 383
JO - Arthritis Care and Research
JF - Arthritis Care and Research
SN - 2151-464X
IS - 3
ER -