Defining clinical remission and clinically inactive disease in juvenile systemic lupus erythematosus (jSLE)

Background

An initial Delphi survey delineated key commonalities for a standard definition of clinical remission and inactive disease in jSLE. However, several additional clarifications were still required.

Objective

To develop a definition and criteria of clinical remission and inactive disease in jSLE.

Methods

A second international Delphi survey was conducted among pediatric rheumatologists. Consensus was set at 75%.

Results

There were 210 respondents. Consensus was achieved regarding the key definitions under consideration (Table 1). Respondents also agreed that a) there should be at most one mild, non-limiting symptom; and b) there can be regular use of several systemic medications in clinical remission. There was no consensus on whether select laboratory tests could be abnormal, and whether regular use of non-steroidal anti-inflammatory drugs with clinical remission was permissible.

Table 1 Definition of Clinical Remission and Clinically Inactive Disease in JSLE

Conclusions

Consensus has been reached on the definition of ‘Clinical Remission’ and ‘Clinically Inactive Disease’ in jSLE. The results of the Delphi process will be used to guide the data-driven development of provisional criteria of clinical remission and inactive disease in jSLE.