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  • Oral presentation
  • Open Access

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

  • 1Email author,
  • 2,
  • 3,
  • 4,
  • 5,
  • 6,
  • 7,
  • 8,
  • 9,
  • 10,
  • 11,
  • 1,
  • 12,
  • 13,
  • 14,
  • 15,
  • 15,
  • 1 and
  • 1
Pediatric Rheumatology20119 (Suppl 1) :O17

https://doi.org/10.1186/1546-0096-9-S1-O17

  • Published:

Keywords

  • Public Health
  • Systemic Lupus Erythematosus
  • Laboratory Test
  • Systemic Medication
  • Clinical Remission

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

Construct

Time frame

Acceptable Use of Medications for Lupus

Consensus

  

Cortico steroids

Immuno suppressives

Preventive medications

Medications to treat SLE damage

 

Clinically Inactive Disease

Time-point

Yes

Yes

Yes

Yes

94% (156/166)

Clinical Remission on Medication

Time-period: ≥ 6 months

Yes

Yes

Yes

Yes

96% (159/166)

Clinical Remission on Preventive Medication

Time-period: ≥ 6 montHs

No

No

Yes

Yes

95% (154/162)

Clinical Remission Off Medication

Time-period: ≥ 12 months

No

No

No

Yes

86% (140/162)

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.

Authors’ Affiliations

(1)
Cincinnati Children's Med Ctr, USA
(2)
Duke Children’s Hosp, USA
(3)
Cohen Children’s Medical Ctr, USA
(4)
Children’s Memorial Hosp, USA
(5)
Nationwide Children’s Hosp, USA
(6)
University of Chicago Comer Children‘s Hosp, USA
(7)
MetroHealth Medical Center, OH, USA
(8)
Children’s Hosp at Oklahoma University, USA
(9)
BC Children’s Hosp, Canada
(10)
The Hospital for Sick Children, Canada
(11)
University of Cincinnati, OH, USA
(12)
Royal Liverpool Children’s NHS Trust, UK
(13)
Hospital General de Niños Pedro de Elizalde, Argentina
(14)
Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires, Argentina
(15)
Istituto G. Gaslini, University of Genova, Italy

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