6533b839fe1ef96bd12a5b0e
RESEARCH PRODUCT
American College of Rheumatology Provisional Criteria for Clinically Relevant Improvement in Children and Adolescents With Childhood-Onset Systemic Lupus Erythematosus
Hermine I BrunnerMichael J HollandMichael W BeresfordStacy P ArdoinSimone AppenzellerClovis A SilvaFrancisco FloresBeatrice GoilavPinar Ozge Avar AydinScott E WenderferDeborah M LevyAngelo RavelliRaju KhubchandaniTadej AvcinMarisa S Klein-gitelmanNicolino RupertoBrian M FeldmanJun YingCristina BattagliottiMaria Isabel BruscoRuben CutticaCarmen De CuntoGraciela EspadaMaximiliano FarfanStella GarayMaria MarcantoniAlvarez MarcelaSilvia MeiorinMaria Elena RamaRicardo RussoCarolina Torre WalshCelso ZamparoNavid AdibJonathan AkikusaChristina BorosSenq J LeeDamien MckaySusan PiperRik JoosBlanca BicaLeonardo CamposAndre CavalcantiRogerio Do PradoAmanda Donner-malikiTaciana FernandesAdriana FonsecaRozana Gasparello De AlmeidaAndressa GuarientoCatherine GusmanFernanda Jusan FiorotSheila Knupp OliveiraClaudio LenLucia M Arruda CamposSandra MachadoLuciana MarquesLuciana Martins De CarvalhoRodrigo MoulinSoraya PedrosoGecilmara PileggiPaulo Roberto S RomanelliClaudia Saad-magalhaesAna SakamotoMaria Carolina SantosMarco Felipe SilvaPaulo SpellingFlavio SztajnbokMaria TerreriDavid CabralGaelle ChedevilleJanet EllsworthAdam HuberLori TuckerKristin HoughtonArturo BorzutzkyMabel LadinoXimena NorambuenaRuth ErasoAngela MosqueraMonica VelasquezMiroslav HarjacekMarija JelusicCecilia Coto HermosillaPavla DolezalovaSusan NielsenCarmen TineoMauricio AlegriaFrank DresslerDirk FoellGerd GanserClaas HinzeMarkus HufnagelThomas LutzRalf TrauzeddelSorina BoiuMaria TrachanaElena TsitsamiMayra CifuentesIlonka OrbanAmita AggarwalSujata SawhneyYonatan Butbul AvielRolando CimazMaria Cristina MaggioIngrid Rumba-rozenfeldeSoad HashadSern Chin LimCarlos AbudRuben Burgos-vargasRoberto Carreno-manjarrezSandra Enciso PelaezHayde Hernandez-huiracheRocio Maldonado VelazquezJavier OrozcoAna Luisa Rodriguez-lozanoOmar Ernesto Rojas PachecoLuz Maria Suarez LariosGabriel VegaJulia Veronica Ramirez MiramontesIvon Karina Ruiz LopezSylvia KamphuisDieneke Schonenberg-meinemaAnthony ConcannonJaqueline YanMartha Jarquin JaimeSafiya Al AbrawiCynthia VegaJorge Lopez-benitezAmparo Ibanez EstrellaTatiana MiravalLeonia DansKaren Joy KimsengVioletta Opoka-winiarskaLidia Rutkowska-sakElzbieta SmolewskaMarta CondeMargarida GuedesEnid Del ValleAna Quintero-del RioConstantin AilioaieMihaela SparchezEkaterina AlekseevaVladimir KeltsevSulaiman Al-mayoufAbdurhman AsiriWafaa SuwairiGordana SusicGordana Vijatov-djuricElizabeth AngThaschawee ArkachaisriAlina-lucica BoteanuJuan Carlos Lopez-robledilloMarta Medrano San IldefonsoConsuelo ModestoInmaculada CalvoJorge Sotoca-fernandezIsabel BoltSoamarat VilaiyukEslam Al-abadiEileen BaildamLampros FotisClare PainClarissa PilkingtonKhalid AbulabanFatima Barbar-smileyBryce BinstadtJohn BohnsackAlexis BoneparthDiane BrownPeter ChiraRandy CronFatma DedeogluAnne EberhardAbraham GedaliaAlexei GromBeatrice GoilavMichael HenricksonChristine HomJennifer HugginsRita JerathJordan JonesLawrence JungDaniel KingsburyJamie LaiDaniel LovellKabita NandaJames NoctonJudyann OlsonKathleen O'neilKaren OnelLynn PunaroAndreas ReiffKelly Rouster-stevensNatasha RuthKen SchiklerKara Murphy SchmidtGrant SchulertBracha ShahamNora SingerJudith SmithRobert SundelGrant SyversonPatricia Vega-fernandezRichard VeheLinda Wagner-weinerJuan CametoRosario JuradoIrama MaldonadoPaediat Rheumatology Int Trial OrgPediat Rheumatology Collaborativesubject
medicine.medical_specialtyOutcome AssessmentHealth Care/methodsAdolescentDelphi TechniqueAntirheumatic Agents/therapeutic useSeverity of Illness IndexChild healthArticle03 medical and health sciences0302 clinical medicineRheumatologyInternal medicineSeverity of illnessOutcome Assessment Health CaremedicinePediatric nephrologyHumansLupus Erythematosus Systemicskin and connective tissue diseasesChild030203 arthritis & rheumatologySystemic lupus erythematosusLupus erythematosusLupus ErythematosusReceiver operating characteristicbusiness.industryConsensus conferencechildhood-onset systemic lupus erythematosusOutcome Assessment Health Care/methodsmedicine.diseaseRheumatologyRheumatologySystemic lupus erythematosusautoimmune inflammatory diseaseAntirheumatic AgentsLupus Erythematosus Systemic/drug therapySystemic/drug therapybusinessAlgorithmsdescription
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.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2019-05-01 | Arthritis Care and Research |