International Consensus for the Dosing of Corticosteroids in Childhood-Onset Systemic Lupus Erythematosus With Proliferative Lupus Nephritis

International Consensus for the Dosing of Corticosteroids in Childhood-Onset Systemic Lupus Erythematosus With Proliferative Lupus Nephritis

Objective: To develop a standardized steroid dosing regimen (SSR) for physicians treating childhood-onset systemic lupus erythematosus (SLE) complicated by lupus nephritis (LN), using consensus formation methodology. Methods: Parameters influencing corticosteroid (CS) dosing were identified (step 1)...

Full description

Bibliographic Details
Published in:Arthritis and Rheumatology
Main Authors: Chalhoub N.E.; Wenderfer S.E.; Levy D.M.; Rouster-Stevens K.; Aggarwal A.; Savani S.I.; Ruth N.M.; Arkachaisri T.; Qiu T.; Merritt A.; Onel K.; Goilav B.; Khubchandani R.P.; Deng J.; Fonseca A.R.; Ardoin S.P.; Ciurtin C.; Kasapcopur O.; Jelusic M.; Huber A.M.; Ozen S.; Klein-Gitelman M.S.; Appenzeller S.; Cavalcanti A.; Fotis L.; Lim S.C.; Silva R.M.; Miramontes J.R.; Rosenwasser N.L.; Saad-Magalhaes C.; Schonenberg-Meinema D.; Scott C.; Silva C.A.; Enciso S.; Terreri M.T.; Torres-Jimenez A.-R.; Trachana M.; Al-Mayouf S.M.; Devarajan P.; Huang B.; Brunner H.I.; Abulaban K.; Aguiar C.; Ahn S.-Y.; Akoghlanian S.; Al-Abrawi S.; Aljaberi N.; Alperin R.; Angeles-Han S.; Ardalan K.; Bader-Meunier B.; Balboni I.; Barbar-Smiley F.; Baxter S.; Beary J.; Boneparth A.; Brakeman P.; Bridges J.; Burgos-Vargas R.; Cabral D.A.; Cameto J.; Carter C.; Chang J.; Chédeville G.; Chhakchhuak C.; Chiraseveenuprapund P.; Cifuentes Alvarado M.; Concannon A.; Cooper J.; Cron R.; De Carvalho L.M.; De Quattro K.; De Ranieri D.; Dizon B.; Donnelly Wrigley C.; Duong M.D.; Eberhard A.; Ede K.; Edelheit B.; Edens C.; Espada G.; Farhey Y.; Flores F.; Fritz D.; Ganguli S.; Gilbert M.; Gittar P.; Greenbaum L.; Grom A.; Gulati G.; Harry O.; Hayward K.; Henrickson M.; Hersh A.; Hiraki L.; Hiskey M.; Hoffmann S.; Hollander M.; Hom C.; Houk L.; Houk J.B.; Hsieh E.W.Y.; Hsu J.; Jensen P.; Joos R.; Jurado R.; Jusan Fiorot F.; Kallash M.; Kamphuis S.; Keltsev V., (deceased); Khanna S.; Kim S.; Kimseng K.J.; Knight A.; Kunder R.; Lai J.; Laskin B.; Lewandowski L.; Lim L.; Linda W.-W.; Lo M.; Lovell D.; Luggen M.; Madison J.; Mansuri A.; Martin L.; Mason S.; Miller M.; Mina R.; Mohammed A.; Moncrieffe H.; Moorthy L.; Morgan E.; Mosquera A.; Muntel E.; Muscal E.; Myones B.; Nocton J.; Ogbu E.; Okamura D.; Olson J.; Orrock J.; Paim-Marques L.; Pain C.; Park C.; Patel P.; Pereira M.; Prado R.D.; Radhakrishna S.; Rheault M.; Ridgway W.; Riskalla M.; Ronis T.; Sadun R.; Sagcal-Gironella A.C.; Santos M.C.; Schikler K.; AL Suwairi W.; Siddiqi N.; Silva M.F.; Singh-Grewal D.; Smitherman E.; Smolewska E.; Son M.B.; Srinivasalu H.; Sule S.; Susic G.; Syed R.; Thatayatikom A.; Ting T.; Toth M.; Turnier J.; Vashisht P.; Vega Fernandez P.; Velasquez M.; von Scheven E.; Wahezi D.; Ware A.; Wu E.; Yan J.; Yildirim-Toruner C.; Zamparo C.; Zhang Y.; Lawson E.
Format: Article
Language:English
Published: John Wiley and Sons Inc 2022
Online Access:https://www.scopus.com/inward/record.uri?eid=2-s2.0-85122264560&doi=10.1002%2fart.41930&partnerID=40&md5=4b0fe94f81329201c0fcfca9b0e59369
id 2-s2.0-85122264560
spelling 2-s2.0-85122264560
Chalhoub N.E.; Wenderfer S.E.; Levy D.M.; Rouster-Stevens K.; Aggarwal A.; Savani S.I.; Ruth N.M.; Arkachaisri T.; Qiu T.; Merritt A.; Onel K.; Goilav B.; Khubchandani R.P.; Deng J.; Fonseca A.R.; Ardoin S.P.; Ciurtin C.; Kasapcopur O.; Jelusic M.; Huber A.M.; Ozen S.; Klein-Gitelman M.S.; Appenzeller S.; Cavalcanti A.; Fotis L.; Lim S.C.; Silva R.M.; Miramontes J.R.; Rosenwasser N.L.; Saad-Magalhaes C.; Schonenberg-Meinema D.; Scott C.; Silva C.A.; Enciso S.; Terreri M.T.; Torres-Jimenez A.-R.; Trachana M.; Al-Mayouf S.M.; Devarajan P.; Huang B.; Brunner H.I.; Abulaban K.; Aguiar C.; Ahn S.-Y.; Akoghlanian S.; Al-Abrawi S.; Aljaberi N.; Alperin R.; Angeles-Han S.; Ardalan K.; Bader-Meunier B.; Balboni I.; Barbar-Smiley F.; Baxter S.; Beary J.; Boneparth A.; Brakeman P.; Bridges J.; Burgos-Vargas R.; Cabral D.A.; Cameto J.; Carter C.; Chang J.; Chédeville G.; Chhakchhuak C.; Chiraseveenuprapund P.; Cifuentes Alvarado M.; Concannon A.; Cooper J.; Cron R.; De Carvalho L.M.; De Quattro K.; De Ranieri D.; Dizon B.; Donnelly Wrigley C.; Duong M.D.; Eberhard A.; Ede K.; Edelheit B.; Edens C.; Espada G.; Farhey Y.; Flores F.; Fritz D.; Ganguli S.; Gilbert M.; Gittar P.; Greenbaum L.; Grom A.; Gulati G.; Harry O.; Hayward K.; Henrickson M.; Hersh A.; Hiraki L.; Hiskey M.; Hoffmann S.; Hollander M.; Hom C.; Houk L.; Houk J.B.; Hsieh E.W.Y.; Hsu J.; Jensen P.; Joos R.; Jurado R.; Jusan Fiorot F.; Kallash M.; Kamphuis S.; Keltsev V., (deceased); Khanna S.; Kim S.; Kimseng K.J.; Knight A.; Kunder R.; Lai J.; Laskin B.; Lewandowski L.; Lim L.; Linda W.-W.; Lo M.; Lovell D.; Luggen M.; Madison J.; Mansuri A.; Martin L.; Mason S.; Miller M.; Mina R.; Mohammed A.; Moncrieffe H.; Moorthy L.; Morgan E.; Mosquera A.; Muntel E.; Muscal E.; Myones B.; Nocton J.; Ogbu E.; Okamura D.; Olson J.; Orrock J.; Paim-Marques L.; Pain C.; Park C.; Patel P.; Pereira M.; Prado R.D.; Radhakrishna S.; Rheault M.; Ridgway W.; Riskalla M.; Ronis T.; Sadun R.; Sagcal-Gironella A.C.; Santos M.C.; Schikler K.; AL Suwairi W.; Siddiqi N.; Silva M.F.; Singh-Grewal D.; Smitherman E.; Smolewska E.; Son M.B.; Srinivasalu H.; Sule S.; Susic G.; Syed R.; Thatayatikom A.; Ting T.; Toth M.; Turnier J.; Vashisht P.; Vega Fernandez P.; Velasquez M.; von Scheven E.; Wahezi D.; Ware A.; Wu E.; Yan J.; Yildirim-Toruner C.; Zamparo C.; Zhang Y.; Lawson E.
International Consensus for the Dosing of Corticosteroids in Childhood-Onset Systemic Lupus Erythematosus With Proliferative Lupus Nephritis
2022
Arthritis and Rheumatology
74
2
10.1002/art.41930
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85122264560&doi=10.1002%2fart.41930&partnerID=40&md5=4b0fe94f81329201c0fcfca9b0e59369
Objective: To develop a standardized steroid dosing regimen (SSR) for physicians treating childhood-onset systemic lupus erythematosus (SLE) complicated by lupus nephritis (LN), using consensus formation methodology. Methods: Parameters influencing corticosteroid (CS) dosing were identified (step 1). Data from children with proliferative LN were used to generate patient profiles (step 2). Physicians rated changes in renal and extrarenal childhood-onset SLE activity between 2 consecutive visits and proposed CS dosing (step 3). The SSR was developed using patient profile ratings (step 4), with refinements achieved in a physician focus group (step 5). A second type of patient profile describing the course of childhood-onset SLE for ≥4 months since kidney biopsy was rated to validate the SSR-recommended oral and intravenous (IV) CS dosages (step 6). Patient profile adjudication was based on majority ratings for both renal and extrarenal disease courses, and consensus level was set at 80%. Results: Degree of proteinuria, estimated glomerular filtration rate, changes in renal and extrarenal disease activity, and time since kidney biopsy influenced CS dosing (steps 1 and 2). Considering these parameters in 5,056 patient profile ratings from 103 raters, and renal and extrarenal course definitions, CS dosing rules of the SSR were developed (steps 3–5). Validation of the SSR for up to 6 months post–kidney biopsy was achieved with 1,838 patient profile ratings from 60 raters who achieved consensus for oral and IV CS dosage in accordance with the SSR (step 6). Conclusion: The SSR represents an international consensus on CS dosing for use in patients with childhood-onset SLE and proliferative LN. The SSR is anticipated to be used for clinical care and to standardize CS dosage during clinical trials. © 2021, American College of Rheumatology
John Wiley and Sons Inc
23265191
English
Article
All Open Access; Green Open Access
author Chalhoub N.E.; Wenderfer S.E.; Levy D.M.; Rouster-Stevens K.; Aggarwal A.; Savani S.I.; Ruth N.M.; Arkachaisri T.; Qiu T.; Merritt A.; Onel K.; Goilav B.; Khubchandani R.P.; Deng J.; Fonseca A.R.; Ardoin S.P.; Ciurtin C.; Kasapcopur O.; Jelusic M.; Huber A.M.; Ozen S.; Klein-Gitelman M.S.; Appenzeller S.; Cavalcanti A.; Fotis L.; Lim S.C.; Silva R.M.; Miramontes J.R.; Rosenwasser N.L.; Saad-Magalhaes C.; Schonenberg-Meinema D.; Scott C.; Silva C.A.; Enciso S.; Terreri M.T.; Torres-Jimenez A.-R.; Trachana M.; Al-Mayouf S.M.; Devarajan P.; Huang B.; Brunner H.I.; Abulaban K.; Aguiar C.; Ahn S.-Y.; Akoghlanian S.; Al-Abrawi S.; Aljaberi N.; Alperin R.; Angeles-Han S.; Ardalan K.; Bader-Meunier B.; Balboni I.; Barbar-Smiley F.; Baxter S.; Beary J.; Boneparth A.; Brakeman P.; Bridges J.; Burgos-Vargas R.; Cabral D.A.; Cameto J.; Carter C.; Chang J.; Chédeville G.; Chhakchhuak C.; Chiraseveenuprapund P.; Cifuentes Alvarado M.; Concannon A.; Cooper J.; Cron R.; De Carvalho L.M.; De Quattro K.; De Ranieri D.; Dizon B.; Donnelly Wrigley C.; Duong M.D.; Eberhard A.; Ede K.; Edelheit B.; Edens C.; Espada G.; Farhey Y.; Flores F.; Fritz D.; Ganguli S.; Gilbert M.; Gittar P.; Greenbaum L.; Grom A.; Gulati G.; Harry O.; Hayward K.; Henrickson M.; Hersh A.; Hiraki L.; Hiskey M.; Hoffmann S.; Hollander M.; Hom C.; Houk L.; Houk J.B.; Hsieh E.W.Y.; Hsu J.; Jensen P.; Joos R.; Jurado R.; Jusan Fiorot F.; Kallash M.; Kamphuis S.; Keltsev V.
(deceased); Khanna S.; Kim S.; Kimseng K.J.; Knight A.; Kunder R.; Lai J.; Laskin B.; Lewandowski L.; Lim L.; Linda W.-W.; Lo M.; Lovell D.; Luggen M.; Madison J.; Mansuri A.; Martin L.; Mason S.; Miller M.; Mina R.; Mohammed A.; Moncrieffe H.; Moorthy L.; Morgan E.; Mosquera A.; Muntel E.; Muscal E.; Myones B.; Nocton J.; Ogbu E.; Okamura D.; Olson J.; Orrock J.; Paim-Marques L.; Pain C.; Park C.; Patel P.; Pereira M.; Prado R.D.; Radhakrishna S.; Rheault M.; Ridgway W.; Riskalla M.; Ronis T.; Sadun R.; Sagcal-Gironella A.C.; Santos M.C.; Schikler K.; AL Suwairi W.; Siddiqi N.; Silva M.F.; Singh-Grewal D.; Smitherman E.; Smolewska E.; Son M.B.; Srinivasalu H.; Sule S.; Susic G.; Syed R.; Thatayatikom A.; Ting T.; Toth M.; Turnier J.; Vashisht P.; Vega Fernandez P.; Velasquez M.; von Scheven E.; Wahezi D.; Ware A.; Wu E.; Yan J.; Yildirim-Toruner C.; Zamparo C.; Zhang Y.; Lawson E.
spellingShingle Chalhoub N.E.; Wenderfer S.E.; Levy D.M.; Rouster-Stevens K.; Aggarwal A.; Savani S.I.; Ruth N.M.; Arkachaisri T.; Qiu T.; Merritt A.; Onel K.; Goilav B.; Khubchandani R.P.; Deng J.; Fonseca A.R.; Ardoin S.P.; Ciurtin C.; Kasapcopur O.; Jelusic M.; Huber A.M.; Ozen S.; Klein-Gitelman M.S.; Appenzeller S.; Cavalcanti A.; Fotis L.; Lim S.C.; Silva R.M.; Miramontes J.R.; Rosenwasser N.L.; Saad-Magalhaes C.; Schonenberg-Meinema D.; Scott C.; Silva C.A.; Enciso S.; Terreri M.T.; Torres-Jimenez A.-R.; Trachana M.; Al-Mayouf S.M.; Devarajan P.; Huang B.; Brunner H.I.; Abulaban K.; Aguiar C.; Ahn S.-Y.; Akoghlanian S.; Al-Abrawi S.; Aljaberi N.; Alperin R.; Angeles-Han S.; Ardalan K.; Bader-Meunier B.; Balboni I.; Barbar-Smiley F.; Baxter S.; Beary J.; Boneparth A.; Brakeman P.; Bridges J.; Burgos-Vargas R.; Cabral D.A.; Cameto J.; Carter C.; Chang J.; Chédeville G.; Chhakchhuak C.; Chiraseveenuprapund P.; Cifuentes Alvarado M.; Concannon A.; Cooper J.; Cron R.; De Carvalho L.M.; De Quattro K.; De Ranieri D.; Dizon B.; Donnelly Wrigley C.; Duong M.D.; Eberhard A.; Ede K.; Edelheit B.; Edens C.; Espada G.; Farhey Y.; Flores F.; Fritz D.; Ganguli S.; Gilbert M.; Gittar P.; Greenbaum L.; Grom A.; Gulati G.; Harry O.; Hayward K.; Henrickson M.; Hersh A.; Hiraki L.; Hiskey M.; Hoffmann S.; Hollander M.; Hom C.; Houk L.; Houk J.B.; Hsieh E.W.Y.; Hsu J.; Jensen P.; Joos R.; Jurado R.; Jusan Fiorot F.; Kallash M.; Kamphuis S.; Keltsev V.
(deceased); Khanna S.; Kim S.; Kimseng K.J.; Knight A.; Kunder R.; Lai J.; Laskin B.; Lewandowski L.; Lim L.; Linda W.-W.; Lo M.; Lovell D.; Luggen M.; Madison J.; Mansuri A.; Martin L.; Mason S.; Miller M.; Mina R.; Mohammed A.; Moncrieffe H.; Moorthy L.; Morgan E.; Mosquera A.; Muntel E.; Muscal E.; Myones B.; Nocton J.; Ogbu E.; Okamura D.; Olson J.; Orrock J.; Paim-Marques L.; Pain C.; Park C.; Patel P.; Pereira M.; Prado R.D.; Radhakrishna S.; Rheault M.; Ridgway W.; Riskalla M.; Ronis T.; Sadun R.; Sagcal-Gironella A.C.; Santos M.C.; Schikler K.; AL Suwairi W.; Siddiqi N.; Silva M.F.; Singh-Grewal D.; Smitherman E.; Smolewska E.; Son M.B.; Srinivasalu H.; Sule S.; Susic G.; Syed R.; Thatayatikom A.; Ting T.; Toth M.; Turnier J.; Vashisht P.; Vega Fernandez P.; Velasquez M.; von Scheven E.; Wahezi D.; Ware A.; Wu E.; Yan J.; Yildirim-Toruner C.; Zamparo C.; Zhang Y.; Lawson E.
International Consensus for the Dosing of Corticosteroids in Childhood-Onset Systemic Lupus Erythematosus With Proliferative Lupus Nephritis
author_facet Chalhoub N.E.; Wenderfer S.E.; Levy D.M.; Rouster-Stevens K.; Aggarwal A.; Savani S.I.; Ruth N.M.; Arkachaisri T.; Qiu T.; Merritt A.; Onel K.; Goilav B.; Khubchandani R.P.; Deng J.; Fonseca A.R.; Ardoin S.P.; Ciurtin C.; Kasapcopur O.; Jelusic M.; Huber A.M.; Ozen S.; Klein-Gitelman M.S.; Appenzeller S.; Cavalcanti A.; Fotis L.; Lim S.C.; Silva R.M.; Miramontes J.R.; Rosenwasser N.L.; Saad-Magalhaes C.; Schonenberg-Meinema D.; Scott C.; Silva C.A.; Enciso S.; Terreri M.T.; Torres-Jimenez A.-R.; Trachana M.; Al-Mayouf S.M.; Devarajan P.; Huang B.; Brunner H.I.; Abulaban K.; Aguiar C.; Ahn S.-Y.; Akoghlanian S.; Al-Abrawi S.; Aljaberi N.; Alperin R.; Angeles-Han S.; Ardalan K.; Bader-Meunier B.; Balboni I.; Barbar-Smiley F.; Baxter S.; Beary J.; Boneparth A.; Brakeman P.; Bridges J.; Burgos-Vargas R.; Cabral D.A.; Cameto J.; Carter C.; Chang J.; Chédeville G.; Chhakchhuak C.; Chiraseveenuprapund P.; Cifuentes Alvarado M.; Concannon A.; Cooper J.; Cron R.; De Carvalho L.M.; De Quattro K.; De Ranieri D.; Dizon B.; Donnelly Wrigley C.; Duong M.D.; Eberhard A.; Ede K.; Edelheit B.; Edens C.; Espada G.; Farhey Y.; Flores F.; Fritz D.; Ganguli S.; Gilbert M.; Gittar P.; Greenbaum L.; Grom A.; Gulati G.; Harry O.; Hayward K.; Henrickson M.; Hersh A.; Hiraki L.; Hiskey M.; Hoffmann S.; Hollander M.; Hom C.; Houk L.; Houk J.B.; Hsieh E.W.Y.; Hsu J.; Jensen P.; Joos R.; Jurado R.; Jusan Fiorot F.; Kallash M.; Kamphuis S.; Keltsev V.
(deceased); Khanna S.; Kim S.; Kimseng K.J.; Knight A.; Kunder R.; Lai J.; Laskin B.; Lewandowski L.; Lim L.; Linda W.-W.; Lo M.; Lovell D.; Luggen M.; Madison J.; Mansuri A.; Martin L.; Mason S.; Miller M.; Mina R.; Mohammed A.; Moncrieffe H.; Moorthy L.; Morgan E.; Mosquera A.; Muntel E.; Muscal E.; Myones B.; Nocton J.; Ogbu E.; Okamura D.; Olson J.; Orrock J.; Paim-Marques L.; Pain C.; Park C.; Patel P.; Pereira M.; Prado R.D.; Radhakrishna S.; Rheault M.; Ridgway W.; Riskalla M.; Ronis T.; Sadun R.; Sagcal-Gironella A.C.; Santos M.C.; Schikler K.; AL Suwairi W.; Siddiqi N.; Silva M.F.; Singh-Grewal D.; Smitherman E.; Smolewska E.; Son M.B.; Srinivasalu H.; Sule S.; Susic G.; Syed R.; Thatayatikom A.; Ting T.; Toth M.; Turnier J.; Vashisht P.; Vega Fernandez P.; Velasquez M.; von Scheven E.; Wahezi D.; Ware A.; Wu E.; Yan J.; Yildirim-Toruner C.; Zamparo C.; Zhang Y.; Lawson E.
author_sort Chalhoub N.E.; Wenderfer S.E.; Levy D.M.; Rouster-Stevens K.; Aggarwal A.; Savani S.I.; Ruth N.M.; Arkachaisri T.; Qiu T.; Merritt A.; Onel K.; Goilav B.; Khubchandani R.P.; Deng J.; Fonseca A.R.; Ardoin S.P.; Ciurtin C.; Kasapcopur O.; Jelusic M.; Huber A.M.; Ozen S.; Klein-Gitelman M.S.; Appenzeller S.; Cavalcanti A.; Fotis L.; Lim S.C.; Silva R.M.; Miramontes J.R.; Rosenwasser N.L.; Saad-Magalhaes C.; Schonenberg-Meinema D.; Scott C.; Silva C.A.; Enciso S.; Terreri M.T.; Torres-Jimenez A.-R.; Trachana M.; Al-Mayouf S.M.; Devarajan P.; Huang B.; Brunner H.I.; Abulaban K.; Aguiar C.; Ahn S.-Y.; Akoghlanian S.; Al-Abrawi S.; Aljaberi N.; Alperin R.; Angeles-Han S.; Ardalan K.; Bader-Meunier B.; Balboni I.; Barbar-Smiley F.; Baxter S.; Beary J.; Boneparth A.; Brakeman P.; Bridges J.; Burgos-Vargas R.; Cabral D.A.; Cameto J.; Carter C.; Chang J.; Chédeville G.; Chhakchhuak C.; Chiraseveenuprapund P.; Cifuentes Alvarado M.; Concannon A.; Cooper J.; Cron R.; De Carvalho L.M.; De Quattro K.; De Ranieri D.; Dizon B.; Donnelly Wrigley C.; Duong M.D.; Eberhard A.; Ede K.; Edelheit B.; Edens C.; Espada G.; Farhey Y.; Flores F.; Fritz D.; Ganguli S.; Gilbert M.; Gittar P.; Greenbaum L.; Grom A.; Gulati G.; Harry O.; Hayward K.; Henrickson M.; Hersh A.; Hiraki L.; Hiskey M.; Hoffmann S.; Hollander M.; Hom C.; Houk L.; Houk J.B.; Hsieh E.W.Y.; Hsu J.; Jensen P.; Joos R.; Jurado R.; Jusan Fiorot F.; Kallash M.; Kamphuis S.; Keltsev V.
title International Consensus for the Dosing of Corticosteroids in Childhood-Onset Systemic Lupus Erythematosus With Proliferative Lupus Nephritis
title_short International Consensus for the Dosing of Corticosteroids in Childhood-Onset Systemic Lupus Erythematosus With Proliferative Lupus Nephritis
title_full International Consensus for the Dosing of Corticosteroids in Childhood-Onset Systemic Lupus Erythematosus With Proliferative Lupus Nephritis
title_fullStr International Consensus for the Dosing of Corticosteroids in Childhood-Onset Systemic Lupus Erythematosus With Proliferative Lupus Nephritis
title_full_unstemmed International Consensus for the Dosing of Corticosteroids in Childhood-Onset Systemic Lupus Erythematosus With Proliferative Lupus Nephritis
title_sort International Consensus for the Dosing of Corticosteroids in Childhood-Onset Systemic Lupus Erythematosus With Proliferative Lupus Nephritis
publishDate 2022
container_title Arthritis and Rheumatology
container_volume 74
container_issue 2
doi_str_mv 10.1002/art.41930
url https://www.scopus.com/inward/record.uri?eid=2-s2.0-85122264560&doi=10.1002%2fart.41930&partnerID=40&md5=4b0fe94f81329201c0fcfca9b0e59369
description Objective: To develop a standardized steroid dosing regimen (SSR) for physicians treating childhood-onset systemic lupus erythematosus (SLE) complicated by lupus nephritis (LN), using consensus formation methodology. Methods: Parameters influencing corticosteroid (CS) dosing were identified (step 1). Data from children with proliferative LN were used to generate patient profiles (step 2). Physicians rated changes in renal and extrarenal childhood-onset SLE activity between 2 consecutive visits and proposed CS dosing (step 3). The SSR was developed using patient profile ratings (step 4), with refinements achieved in a physician focus group (step 5). A second type of patient profile describing the course of childhood-onset SLE for ≥4 months since kidney biopsy was rated to validate the SSR-recommended oral and intravenous (IV) CS dosages (step 6). Patient profile adjudication was based on majority ratings for both renal and extrarenal disease courses, and consensus level was set at 80%. Results: Degree of proteinuria, estimated glomerular filtration rate, changes in renal and extrarenal disease activity, and time since kidney biopsy influenced CS dosing (steps 1 and 2). Considering these parameters in 5,056 patient profile ratings from 103 raters, and renal and extrarenal course definitions, CS dosing rules of the SSR were developed (steps 3–5). Validation of the SSR for up to 6 months post–kidney biopsy was achieved with 1,838 patient profile ratings from 60 raters who achieved consensus for oral and IV CS dosage in accordance with the SSR (step 6). Conclusion: The SSR represents an international consensus on CS dosing for use in patients with childhood-onset SLE and proliferative LN. The SSR is anticipated to be used for clinical care and to standardize CS dosage during clinical trials. © 2021, American College of Rheumatology
publisher John Wiley and Sons Inc
issn 23265191
language English
format Article
accesstype All Open Access; Green Open Access
record_format scopus
collection Scopus
_version_ 1809678480872308736

Similar Items