International Consensus for the Dosing of Corticosteroids in Childhood‐Onset Systemic Lupus Erythematosus With Proliferative Lupus Nephritis. Issue 2 (4th January 2022)

• Record Type: Journal Article
• Authors: Chalhoub, Nathalie E.; Wenderfer, Scott E.; Levy, Deborah M.; Rouster‐Stevens, Kelly; Aggarwal, Amita; Savani, Sonia I.; Ruth, Natasha M.; Arkachaisri, Thaschawee; Qiu, Tingting; Merritt, Angela; Onel, Karen; Goilav, Beatrice; Khubchandani, Raju P.; Deng, Jianghong; Fonseca, Adriana R.; Ardoin, Stacy P.; Ciurtin, Coziana; Kasapcopur, Ozgur; Jelusic, Marija; Huber, Adam M.; Ozen, Seza; Klein‐Gitelman, Marisa S.; Appenzeller, Simone; Cavalcanti, André; Fotis, Lampros; Lim, Sern Chin; Silva, Rodrigo M.; Miramontes, Julia Ramírez‐; Rosenwasser, Natalie L.; Saad‐Magalhaes, Claudia; Schonenberg‐Meinema, Dieneke; Scott, Christiaan; Silva, Clovis A.; Enciso, Sandra; Terreri, Maria T.; Torres‐Jimenez, Alfonso‐Ragnar; Trachana, Maria; Al‐Mayouf, Sulaiman M.; Devarajan, Prasad; Huang, Bin; Brunner, Hermine I.;
• Other Names: Abulaban Khalid investigator.; Aguiar Cassyanne investigator.; Ahn Sun‐Young investigator.; Akoghlanian Shoghik investigator.; Al‐Abrawi Safiya investigator.; Aljaberi Najla investigator.; Alperin Risa investigator.; Angeles‐Han Sheila investigator.; Ardalan Kaveh investigator.; Bader‐Meunier Brigitte investigator.; Balboni Imelda investigator.; Barbar‐Smiley Fatima investigator.; Baxter Sarah investigator.; Beary John investigator.; Boneparth Alexis investigator.; Brakeman Paul investigator.; Bridges John investigator.; Burgos‐Vargas Ruben investigator.; Cabral David A. investigator.; Cameto Juan investigator.; Carter Caitlin investigator.; Chang Joyce investigator.; Chédeville Gaëlle investigator.; Chhakchhuak Christine investigator.; Chiraseveenuprapund Peter investigator.; Cifuentes Alvarado Mayra investigator.; Concannon Anthony investigator.; Cooper Jennifer investigator.; Cron Randy investigator.; De Carvalho Luciana Martins investigator.; De Quattro Kimberly investigator.; De Ranieri Deirdre investigator.; Dizon Brian investigator.; Donnelly Wrigley Catherine investigator.; Duong Minh Dien investigator.; Eberhard Anne investigator.; Ede Kaleo investigator.; Edelheit Barbara investigator.; Edens Cuoghi investigator.; Espada Graciela investigator.; Farhey Yolanda investigator.; Flores Francisco investigator.; Fritz Deborah investigator.; Ganguli Suhas investigator.; Gilbert Mileka investigator.; Gittar Patsy investigator.; Greenbaum Larry investigator.; Grom Alexei investigator.; Gulati Gaurav investigator.; Harry Onengiya investigator.; Hayward Kristen investigator.; Henrickson Michael investigator.; Hersh Aimee investigator.; Hiraki Linda investigator.; Hiskey Megan investigator.; Hoffmann Sarah investigator.; Hollander Matthew investigator.; Hom Christine investigator.; Houk Lawrence investigator.; Houk J. Brian investigator.; Hsieh Elena W.Y. investigator.; Hsu Joyce investigator.; Jensen Paul investigator.; Joos Rik investigator.; Jurado Rosario investigator.; Jusan Fiorot Fernanda investigator.; Kallash Mahmoud investigator.; Kamphuis Sylvia investigator.; Keltsev Vladimir investigator.; Khanna Surabhi investigator.; Kim Susan investigator.; Kimseng Karen Joy investigator.; Knight Andrea investigator.; Kunder Rebecca investigator.; Lai Jamie investigator.; Laskin Benjamin investigator.; Lewandowski Laura investigator.; Lim Lily investigator.; Linda Wagner‐Weiner investigator.; Lo Mindy investigator.; Lovell Daniel investigator.; Luggen Michael investigator.; Madison Jacqueline investigator.; Mansuri Asif investigator.; Martin Lorena investigator.; Mason Sherene investigator.; Miller Michael investigator.; Mina Rina investigator.; Mohammed Abdul investigator.; Moncrieffe Halima investigator.; Moorthy Lakshmi investigator.; Morgan Esi investigator.; Mosquera Angela investigator.; Muntel Emily investigator.; Muscal Eyal investigator.; Myones Barry investigator.; Nocton James investigator.; Ogbu Ekemini investigator.; Okamura Daryl investigator.; Olson Judyann investigator.; Orrock Janet investigator.; Paim‐Marques Luciana investigator.; Pain Clare investigator.; Park Catherine investigator.; Patel Pooja investigator.; Pereira Maria investigator.; Prado Rogerio do investigator.; Radhakrishna Suhas investigator.; Rheault Michelle investigator.; Ridgway William investigator.; Riskalla Mona investigator.; Ronis Tova investigator.; Sadun Rebecca investigator.; Sagcal‐Gironella Anna Carmela investigator.; Santos Maria carolina investigator.; Schikler Kenneth investigator.; AL Suwairi Wafaa investigator.; Siddiqi Nabeela investigator.; Silva Marco Felipe investigator.; Singh‐Grewal Davinder investigator.; Smitherman Emily investigator.; Smolewska Elzbieta investigator.; Son Mary Beth investigator.; Srinivasalu Hemalatha investigator.; Sule Sangeeta investigator.; Susic Gordana investigator.; Syed Reema investigator.; Thatayatikom Akaluck investigator.; Ting Tracy investigator.; Toth Mary investigator.; Turnier Jessica investigator.; Vashisht Priyanka investigator.; Vega Fernandez Patricia investigator.; Velasquez Monica investigator.; von Scheven Emily investigator.; Wahezi Dawn investigator.; Ware Avis investigator.; Wu Eveline investigator.; Yan Jacqueline investigator.; Yildirim‐Toruner Cagri investigator.; Zamparo Celso investigator.; Zhang Yujuan investigator.; Lawson Erica investigator.;
• Is Part Of: Arthritis & rheumatology. Volume 74:Issue 2(2022)
• Page Start: 263
• Page End: 273
• Publication Date: 2022-01-04
• Subjects: Arthritis -- Periodicals; Rheumatism -- Periodicals; 616.72
• DOI: 10.1002/art.41930
• Languages: English
• ISSNs: 2326-5191

Abstract

Abstract : Objective: To develop a standardized steroid dosing regimen (SSR) for physicians treating childhood‐onset systemic lupus erythematosus (SLE) complicated by lupus nephritis (LN), using consensus formation methodology. Methods: Parameters influencing corticosteroid (CS) dosing were identified (step 1). Data from children with proliferative LN were used to generate patient profiles (step 2). Physicians rated changes in renal and extrarenal childhood‐onset SLE activity between 2 consecutive visits and proposed CS dosing (step 3). The SSR was developed using patient profile ratings (step 4), with refinements achieved in a physician focus group (step 5). A second type of patient profile describing the course of childhood‐onset SLE for ≥4 months since kidney biopsy was rated to validate the SSR‐recommended oral and intravenous (IV) CS dosages (step 6). Patient profile adjudication was based on majority ratings for both renal and extrarenal disease courses, and consensus level was set at 80%. Results: Degree of proteinuria, estimated glomerular filtration rate, changes in renal and extrarenal disease activity, and time since kidney biopsy influenced CS dosing (steps 1 and 2). Considering these parameters in 5, 056 patient profile ratings from 103 raters, and renal and extrarenal course definitions, CS dosing rules of the SSR were developed (steps 3–5). Validation of the SSR for up to 6 months post–kidney biopsy was achieved with 1, 838 patient profile ratings from 60 raters who achieved consensus for oral and IV CS dosage in accordance with the SSR (step 6). Conclusion: The SSR represents an international consensus on CS dosing for use in patients with childhood‐onset SLE and proliferative LN. The SSR is anticipated to be used for clinical care and to standardize CS dosage during clinical trials.