Smith, Eve Mary Dorothy, Aggarwal, Amita, Ainsworth, Jenny, Al-Abadi, Eslam, Avcin, Tadej, Bortey, Lynette, Burnham, Jon, Ciurtin, Coziana, Hedrich, Christian M 
ORCID: 0000-0002-1295-6179, Kamphuis, Sylvia et al (show 13 more authors)
(2023)
Towards development of treat to target (T2T) in childhood-onset systemic lupus erythematosus: PReS-endorsed overarching principles and points-to-consider from an international task force.
ANNALS OF THE RHEUMATIC DISEASES, 82 (6).
pp. 788-798.
Abstract
<h4>Objectives</h4>Application of 'treat-to-target' (T2T) in childhood-onset systemic lupus erythematosus (cSLE) may improve care and health outcomes. This initiative aimed to harmonise existing evidence and expert opinion regarding T2T for cSLE.<h4>Methods</h4>An international T2T Task Force was formed of specialists in paediatric rheumatology, paediatric nephrology, adult rheumatology, patient and parent representatives. A steering committee formulated a set of draft overarching principles and points-to-consider, based on evidence from systematic literature review. Two on-line preconsensus meeting Delphi surveys explored healthcare professionals' views on these provisional overarching principles and points-to-consider. A virtual consensus meeting employed a modified nominal group technique to discuss, modify and vote on each overarching principle/point-to-consider. Agreement of >80% of Task Force members was considered consensus.<h4>Results</h4>The Task Force agreed on four overarching principles and fourteen points-to-consider. It was agreed that both treatment targets and therapeutic strategies should be subject to shared decision making with the patient/caregivers, with full remission the preferred target, and low disease activity acceptable where remission cannot be achieved. Important elements of the points-to-consider included: aiming for prevention of flare and organ damage; glucocorticoid sparing; proactively addressing factors that impact health-related quality of life (fatigue, pain, mental health, educational challenges, medication side effects); and aiming for maintenance of the target over the long-term. An extensive research agenda was also formulated.<h4>Conclusions</h4>These international, consensus agreed overarching principles and points-to-consider for T2T in cSLE lay the foundation for future T2T approaches in cSLE, endorsed by the Paediatric Rheumatology European Society.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Lupus Erythematosus, Systemic, Health services research, Glucocorticoids, Autoimmune Diseases, Outcome and Process Assessment, Health Care |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 17 Jan 2023 15:44 |
| Last Modified: | 18 May 2023 11:16 |
| DOI: | 10.1136/ard-2022-223328 |
| Open Access URL: | http://dx.doi.org/10.1136/ard-2022-223328 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3167103 |
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