Chalhoub, N;
Wenderfer, S;
Levy, D;
Rouster-Stevens, K;
Aggarwal, A;
Savani, S;
Ruth, N;
... Brunner, H; + view all
(2022)
International Consensus For The Dosing Of Corticosteroids In Childhood-Onset Systemic Lupus Erythematosus With Proliferative Lupus Nephritis.
Arthritis & Rheumatism
, 74
(2)
pp. 263-273.
10.1002/art.41930.
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Ciurtin_Arthritis Rheumatology - 2021 - Chalhoub - International Consensus For The Dosing Of Corticosteroids In Childhood‐Onset.pdf - Accepted Version Download (12MB) | Preview |
Abstract
Objective: To develop a Standardized Steroid dosing Regimen (SSR) by physicians treating childhood-onset systemic lupus erythematosus (cSLE) 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 (PP) (Step-2). Physicians rated change in activity of renal and extra-renal cSLE between two consecutive visits and proposed CS dosing (Step-3). Using PP ratings, the SSR was developed (Step-4) with refinements achieved in a physician focus group (Step-5). A second type of PP describing cSLE course for ≥4 months since kidney biopsy were rated to validate the SSR-recommended oral and intravenous CS-dosages (Step-6). PP adjudication was based on majority ratings for both renal and extra-renal disease courses, and consensus level was set at 80%. / Results: Degree of proteinuria, estimated glomerular filtration rate, change in renal and extra-renal disease activity, and time since kidney biopsy influenced CS dosing (Steps-1/2). Considering these parameters in 5,056 PP-ratings from 103 raters, and renal and extra-renal 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 PP-ratings from 60 raters who achieved consensus for oral and intravenous CS dosage as per the SSR (Step-6). / Conclusion: The SSR represents an international consensus on CS dosing for use in patients with cSLE and proliferative LN. The SSR is anticipated to be used for clinical care and standardize CS-dosage during clinical trials.
| Type: | Article |
|---|---|
| Title: | International Consensus For The Dosing Of Corticosteroids In Childhood-Onset Systemic Lupus Erythematosus With Proliferative Lupus Nephritis |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1002/art.41930 |
| Publisher version: | https://doi.org/10.1002/art.41930 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Childhood-onset systemic lupus erythematosus, lupus nephritis, corticosteroids treatment |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inflammation |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10131030 |
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