American College of Rheumatology Provisional Criteria for Clinically Relevant Improvement in Children and Adolescents With Childhood‐Onset Systemic Lupus Erythematosus. Issue 5 (25th April 2019)

• Record Type: Journal Article
• Authors: 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
• Other Names: Battagliotti Cristina investigator.; Brusco Maria Isabel investigator.; Cuttica Rubén investigator.; De Cunto Carmen investigator.; Espada Graciela investigator.; Farfan Maximiliano investigator.; Garay Stella investigator.; Marcantoni Maria investigator.; Marcela Alvarez investigator.; Meiorin Silvia investigator.; Rama Maria Elena investigator.; Russo Ricardo investigator.; Torre Walsh Carolina investigator.; Zamparo Celso investigator.; Adib Navid investigator.; Akikusa Jonathan investigator.; Boros Christina investigator.; Lee Senq J. investigator.; Mckay Damien investigator.; Piper Susan investigator.; Joos Rik investigator.; Bica Blanca investigator.; Campos Leonardo investigator.; Cavalcanti André investigator.; do Prado Rogerio investigator.; Donner‐Maliki Amanda investigator.; Fernandes Taciana investigator.; Fonseca Adriana investigator.; Gasparello de Almeida Rozana investigator.; Guariento Andressa investigator.; Gusman Catherine investigator.; Jusan Fiorot Fernanda investigator.; Knupp Oliveira Sheila investigator.; Len Claudio investigator.; Arruda Campos Lucia M. investigator.; Machado Sandra investigator.; Marques Luciana investigator.; Martins de Carvalho Luciana investigator.; Moulin Rodrigo investigator.; Pedroso Soraya investigator.; Pileggi Gecilmara investigator.; Romanelli Paulo Roberto S. investigator.; Saad‐Magalhaes Claudia investigator.; Sakamoto Ana investigator.; Santos Maria Carolina investigator.; Silva Marco Felipe investigator.; Spelling Paulo investigator.; Sztajnbok Slavio investigator.; Terreri Maria investigator.; Cabral David investigator.; Chédeville Gaëlle investigator.; Ellsworth Janet investigator.; Huber Adam investigator.; Tucker Lori investigator.; Houghton Kristin investigator.; Borzutzky Arturo investigator.; Ladino Mabel investigator.; Norambuena Ximena investigator.; Eraso Ruth investigator.; Mosquera Angela investigator.; Velasquez Monica investigator.; Harjacek Miroslav investigator.; Jelusic Marija investigator.; Coto Hermosilla Cecilia investigator.; Dolezalova Pavla investigator.; Nielsen Susan investigator.; Tineo Carmen investigator.; Alegria Mauricio investigator.; Dressler Frank investigator.; Foell Dirk investigator.; Ganser Gerd investigator.; Hinze Claas investigator.; Hufnagel Markus investigator.; Lutz Thomas investigator.; Trauzeddel Ralf investigator.; Boiu Sorina investigator.; Trachana Maria investigator.; Tsitsami Elena investigator.; Cifuentes Mayra investigator.; Orbán Ilonka investigator.; Aggarwal Amita investigator.; Sawhney Sujata investigator.; Butbul Aviel Yonatan investigator.; Cimaz Rolando investigator.; Maggio Maria Cristina investigator.; Rumba‐Rozenfelde Ingrid investigator.; Hashad Soad investigator.; Lim Sern Chin investigator.; Abud Carlos investigator.; Burgos‐Vargas Ruben investigator.; Carreño‐Manjarrez Roberto investigator.; Enciso Pelaez Sandra investigator.; Hernandez‐Huirache Hayde investigator.; Maldonado Velázquez Rocio investigator.; Orozco Javier investigator.; Rodriguez‐Lozano Ana Luisa investigator.; Rojas Pacheco Omar Ernesto investigator.; Suárez Larios Luz Maria investigator.; Vega Gabriel investigator.; Ramírez Miramontes Julia Verónica investigator.; Ruíz Lopez Ivon Karina investigator.; Kamphuis Sylvia investigator.; Schonenberg‐Meinema Dieneke investigator.; Concannon Anthony investigator.; Yan Jaqueline investigator.; Jarquin Jaime Martha investigator.; Al Abrawi Safiya investigator.; Vega Cynthia investigator.; Lopez‐Benitez Jorge investigator.; Ibáñez Estrella Amparo investigator.; Miraval Tatiana investigator.; Dans Leonia investigator.; Kimseng Karen Joy investigator.; Opoka‐Winiarska Violetta investigator.; Rutkowska‐Sak Lidia investigator.; Smolewska Elzbieta investigator.; Conde Marta investigator.; Guedes Margarida investigator.; del Valle Enid investigator.; Quintero‐Del Rio Ana investigator.; Ailioaie Constantin investigator.; Sparchez Mihaela investigator.; Alekseeva Ekaterina investigator.; Keltsev Vladimir investigator.; Al‐Mayouf Sulaiman investigator.; Asiri Abdurhman investigator.; Suwairi Wafaa investigator.; Susic Gordana investigator.; Vijatov‐Djuric Gordana investigator.; Ang Elizabeth investigator.; Arkachaisri Thaschawee investigator.; Boteanu Alina‐Lucica investigator.; Lopez‐Robledillo Juan Carlos investigator.; Medrano San Ildefonso Marta investigator.; Modesto Consuelo investigator.; Calvo Inmaculada investigator.; Sotoca‐Fernandez Jorge investigator.; Bolt Isabel investigator.; Vilaiyuk Soamarat investigator.; Al‐Abadi Eslam investigator.; Baildam Eileen investigator.; Fotis Lampros investigator.; Pain Clare investigator.; Pilkington Clarissa investigator.; Abulaban Khalid investigator.; Barbar‐Smiley Fatima investigator.; Binstadt Bryce investigator.; Bohnsack John investigator.; Boneparth Alexis investigator.; Brown Diane investigator.; Chira Peter investigator.; Cron Randy investigator.; Dedeoglu Fatma investigator.; Eberhard Anne investigator.; Gedalia Abraham investigator.; Grom Alexei investigator.; Henrickson Michael investigator.; Hom Christine investigator.; Huggins Jennifer investigator.; Jerath Rita investigator.; Jones Jordan investigator.; Jung Lawrence investigator.; Kingsbury Daniel investigator.; Lai Jamie investigator.; Lovell Daniel investigator.; Nanda Kabita investigator.; Nocton James investigator.; Olson Judyann investigator.; O'Neil Kathleen investigator.; Onel Karen investigator.; Punaro Lynn investigator.; Reiff Andreas investigator.; Rouster‐Stevens Kelly investigator.; Ruth Natasha investigator.; Schikler Ken investigator.; Murphy Schmidt Kara investigator.; Schulert Grant investigator.; Shaham Bracha investigator.; Singer Nora investigator.; Smith Judith investigator.; Sundel Robert investigator.; Syverson Grant investigator.; Vega‐Fernandez Patricia investigator.; Vehe Richard investigator.; Wagner‐Weiner Linda investigator.; Cameto Juan investigator.; Jurado Rosario investigator.; Maldonado Irama investigator.;
• Is Part Of: Arthritis care & research. Volume 71:Issue 5(2019)
• Page Start: 579
• Page End: 590
• Publication Date: 2019-04-25
• Subjects: Arthritis -- Periodicals; Rheumatism -- Periodicals; 616.72
• DOI: 10.1002/acr.23834
• Languages: English
• ISSNs: 2151-464X

Abstract

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.