American College of Rheumatology Provisional Criteria for Clinically Relevant Improvement in Children and Adolescents With Childhood-Onset Systemic Lupus Erythematosus

Author(s):Show less -

Brunner, Hermine I. ^{[1, 2]} ; Holland, Michael J. ^{[1, 2]} ; Beresford, Michael W. ^{[3, 4]} ; Ardoin, Stacy P. ^{[5, 6, 7]} ; Appenzeller, Simone ^[8] ; Silva, Clovis A. ^[9] ; Flores, Francisco ^{[1, 2]} ; Aydin, Pinar Ozge Avar ^{[1, 2]} ; Wenderfer, Scott E. ^{[10, 11]} ; Levy, Deborah M. ^{[12, 13]} ; Ravelli, Angelo ^[14] ; Khubchandani, Raju ^[15] ; Avcin, Tadej ^[16] ; Klein-Gitelman, Marisa S. ^{[17, 18]} ; Ruperto, Nicolino ^[14] ; Feldman, Brian M. ^{[12, 13]} ; Ying, Jun ^[2] ; Battagliotti, Cristina ; Brusco, Maria Isabel ; Cuttica, Ruben ; De Cunto, Carmen ; Espada, Graciela ; Farfan, Maximiliano ; Garay, Stella ; Marcantoni, Maria ; Marcela, Alvarez ; Meiorin, Silvia ; Rama, Maria Elena ; Russo, Ricardo ; Walsh, Carolina Torre ; Zamparo, Celso ; Adib, Navid ; Akikusa, Jonathan ; Boros, Christina ; Lee, Senq J. ; Mckay, Damien ; Piper, Susan ; Joos, Rik ; Bica, Blanca ; Campos, Leonardo ; Cavalcanti, Andre ; do Prado, Rogerio ; Donner-Maliki, Amanda ; Fernandes, Taciana ; Fonseca, Adriana ; de Almeida, Rozana Gasparello ; Guariento, Andressa ; Gusman, Catherine ; Fiorot, Fernanda Jusan ; Oliveira, Sheila Knupp ; Len, Claudio ; Campos, Lucia M. Arruda ; Machado, Sandra ; Marques, Luciana ; de Carvalho, Luciana Martins ; Moulin, Rodrigo ; Pedroso, Soraya ; Pileggi, Gecilmara ; Romanelli, Paulo Roberto S. ; Saad-Magalhaes, Claudia ; Sakamoto, Ana ; Santos, Maria Carolina ; Silva, Marco Felipe ; Spelling, Paulo ; Sztajnbok, Slavio ; Terreri, Maria ; Cabral, David ; Chedeville, Gaelle ; Ellsworth, Janet ; Huber, Adam ; Tucker, Lori ; Houghton, Kristin ; Borzutzky, Arturo ; Ladino, Mabel ; Norambuena, Ximena ; Eraso, Ruth ; Mosquera, Angela ; Velasquez, Monica ; Harjacek, Miroslav ; Jelusic, Marija ; Hermosilla, Cecilia Coto ; Dolezalova, Pavla ; Nielsen, Susan ; Tineo, Carmen ; Alegria, Mauricio ; Dressler, Frank ; Foell, Dirk ; Ganser, Gerd ; Hinze, Claas ; Hufnagel, Markus ; Lutz, Thomas ; Trauzeddel, Ralf ; Boiu, Sorina ; Trachana, Maria ; Tsitsami, Elena ; Cifuentes, Mayra ; Orban, Ilonka ; Aggarwal, Amita ; Sawhney, Sujata ; Aviel, Yonatan Butbul ; Cimaz, Rolando ; Maggio, Maria Cristina ; Rumba-Rozenfelde, Ingrid ; Hashad, Soad ; Lim, Sern Chin ; Abud, Carlos ; Burgos-Vargas, Ruben ; Carreno-Manjarrez, Roberto ; Enciso Pelaez, Sandra ; Hernandez-Huirache, Hayde ; Maldonado Velazquez, Rocio ; Orozco, Javier ; Rodriguez-Lozano, Ana Luisa ; Rojas Pacheco, Omar Ernesto ; Suarez Larios, Luz Maria ; Vega, Gabriel ; Ramirez Miramontes, Julia Veronica ; Ruiz Lopez, Ivon Karina ; Kamphuis, Sylvia ; Schonenberg-Meinema, Dieneke ; Concannon, Anthony ; Yan, Jaqueline ; Jaime, Martha Jarquin ; Al Abrawi, Safiya ; Vega, Cynthia ; Lopez-Benitez, Jorge ; Estrella, Amparo Ibanez ; Miraval, Tatiana ; Dans, Leonia ; Kimseng, Karen Joy ; Opoka-Winiarska, Violetta ; Rutkowska-Sak, Lidia ; Smolewska, Elzbieta ; Conde, Marta ; Guedes, Margarida ; del Valle, Enid ; Quintero-Del Rio, Ana ; Ailioaie, Constantin ; Sparchez, Mihaela ; Alekseeva, Ekaterina ; Keltsev, Vladimir ; Al-Mayouf, Sulaiman ; Asiri, Abdurhman ; Suwairi, Wafaa ; Susic, Gordana ; Vijatov-Djuric, Gordana ; Ang, Elizabeth ; Arkachaisri, Thaschawee ; Boteanu, Alina-Lucica ; Lopez-Robledillo, Juan Carlos ; San Ildefonso, Marta Medrano ; Modesto, Consuelo ; Calvo, Inmaculada ; Sotoca-Fernandez, Jorge ; Bolt, Isabel ; Vilaiyuk, Soamarat ; Al-Abadi, Eslam ; Baildam, Eileen ; Fotis, Lampros ; Pain, Clare ; Pilkington, Clarissa ; Abulaban, Khalid ; Barbar-Smiley, Fatima ; Binstadt, Bryce ; Bohnsack, John ; Boneparth, Alexis ; Brown, Diane ; Chira, Peter ; Cron, Randy ; Dedeoglu, Fatma ; Eberhard, Anne ; Gedalia, Abraham ; Grom, Alexei ; Goilav, Beatrice ^[19] ; Henrickson, Michael ; Hom, Christine ; Huggins, Jennifer ; Jerath, Rita ; Jones, Jordan ; Jung, Lawrence ; Kingsbury, Daniel ; Lai, Jamie ; Lovell, Daniel ; Nanda, Kabita ; Nocton, James ; Olson, Judyann ; O'Neil, Kathleen ; Onel, Karen ; Punaro, Lynn ; Rouster-Stevens, Andreas Reiff Kelly ; Ruth, Natasha ; Schikler, Ken ; Schmidt, Kara Murphy ; Schulert, Grant ; Shaham, Bracha ; Singer, Nora ; Smith, Judith ; Sundel, Robert ; Syverson, Grant ; Vega-Fernandez, Patricia ; Vehe, Richard ; Wagner-Weiner, Linda ; Cameto, Juan ; Jurado, Rosario ; Maldonado, Irama ; Org, Paediat Rheumatology Int Trial ; Collaborative, Pediat Rheumatology

Affiliation:Show less -

^[1] Cincinnati Childrens Hosp Med Ctr, Cincinnati, OH 45229 - USA

^[2] Univ Cincinnati, Cincinnati, OH - USA

^[3] Inst Translat Med, Liverpool, Merseyside - England

^[4] Alder Hey Childrens NHS Fdn Trust, Liverpool, Merseyside - England

^[5] Ohio State Univ, Columbus, OH 43210 - USA

^[6] Nationwide Childrens Hosp, Columbus, OH - USA

^[7] Wexner Med Ctr, Columbus, OH - USA

^[8] Univ Estadual Campinas, Campinas, SP - Brazil

^[9] Univ Sao Paulo, Childrens Inst, Hosp Clin, HCFMUSP, Sao Paulo - Brazil

^[10] Baylor Coll Med, Houston, TX 77030 - USA

^[11] Baylor Univ, Texas Childrens Hosp, Houston, TX 77030 - USA

^[12] Univ Toronto, Toronto, ON - Canada

^[13] Hosp Sick Children, Toronto, ON - Canada

^[14] Ist Giannina Gaslini, PRINTO, Clin Pediat & Reumatol, Genoa - Italy

^[15] Jaslok Hosp Mumbai, Mumbai, Maharashtra - India

^[16] Univ Childrens Hosp, Univ Med Ctr, Ljubljana - Slovenia

^[17] Northwestern Univ, Feinberg Sch Med, Chicago, IL 60611 - USA

^[18] Ann & Robert Lurie Childrens Hosp Chicago, Chicago, IL - USA

^[19] Albert Einstein Coll Med, Childrens Hosp Montefiore, Bronx, NY 10467 - USA

• Document type: Journal article
• Source: ARTHRITIS CARE & RESEARCH; v. 71, n. 5, p. 579-590, MAY 2019.
• Web of Science Citations: 0

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 (CRIcSLE). Methods Pediatric nephrology and rheumatology subspecialists (n = 213) experienced in cSLE management were invited to define CRIcSLE and rate a total of 433 unique patient profiles for the presence/absence of CRIcSLE. 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 CRIcSLE 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 CRIcSLE (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. (AU)

• FAPESP's process: 15/03756-4 - Assessment of relevance of blood levels of drugs in the monitoring rheumatic autoimmune diseases: safety, effectiveness and adherence to therapy
• Grantee: Eloisa Silva Dutra de Oliveira Bonfá
• Support Opportunities: Research Projects - Thematic Grants