American College of Rheumatology Provisional Criteria for Clinically Relevant Improvement in Children and Adolescents With Childhood-Onset Systemic Lupus Erythematosus
Por:
Brunner H.I., Holland M.J., Beresford M.W., Ardoin S.P., Appenzeller S., Silva C.A., Flores F., Goilav B., Avar Aydin P.O., Wenderfer S.E., Levy D.M., Ravelli A., Khubchandani R., Avcin T., Klein-Gitelman M.S., Ruperto N., Feldman B.M., Ying J., Battagliotti C., Brusco M.I., Cuttica R., De Cunto C., Espada G., Farfan M., Garay S., Marcantoni M., Marcela A., Meiorin S., Rama M.E., Russo R., Torre Walsh C., Zamparo C., Adib N., Akikusa J., Boros C., Lee S.J., Mckay D., Piper S., Joos R., Bica B., Campos L., Cavalcanti A., do Prado R., Donner-Maliki A., Fernandes T., Fonseca A., Gasparello de Almeida R., Guariento A., Gusman C., Jusan Fiorot F., Knupp Oliveira S., Len C., Arruda Campos L.M., Machado S., Marques L., Martins de Carvalho L., Moulin R., Pedroso S., Pileggi G., Romanelli P.R.S., Saad-Magalhaes C., Sakamoto A., Santos M.C., Silva M.F., Spelling P., Sztajnbok S., Terreri M., Cabral D., Chédeville G., Ellsworth J., Huber A., Tucker L., Houghton K., Borzutzky A., Ladino M., Norambuena X., Eraso R., Mosquera A., Velasquez M., Harjacek M., Jelusic M., Coto Hermosilla C., Dolezalova P., Nielsen S., Tineo C., Alegria M., Dressler F., Foell D., Ganser G., Hinze C., Hufnagel M., Lutz T., Trauzeddel R., Boiu S., Trachana M., Tsitsami E., Cifuentes M., Orbán I., Aggarwal A., Sawhney S., Butbul Aviel Y., Cimaz R., Maggio M.C., Rumba-Rozenfelde I., Hashad S., Lim S.C., Abud C., Burgos-Vargas R., Carreño-Manjarrez R., Enciso Pelaez S., Hernandez-Huirache H., Maldonado Velázquez R., Orozco J., Rodriguez-Lozano A.L., Rojas Pacheco O.E., Suárez Larios L.M., Vega G., Ramírez Miramontes J.V., Ruíz Lopez I.K., Kamphuis S., Schonenberg-Meinema D., Concannon A., Yan J., Jarquin Jaime M., Al Abrawi S., Vega C., Lopez-Benitez J., Ibáñez Estrella A., Miraval T., Dans L., Kimseng K.J., Opoka-Winiarska V., Rutkowska-Sak L., Smolewska E., Conde M., Guedes M., del Valle E., Quintero-Del Rio A., Ailioaie C., Sparchez M., Alekseeva E., Keltsev V., Al-Mayouf S., Asiri A., Suwairi W., Susic G., Vijatov-Djuric G., Ang E., Arkachaisri T., Boteanu A.-L., Lopez-Robledillo J.C., Medrano San Ildefonso M., Modesto C., Calvo I., Sotoca-Fernandez J., Bolt I., Vilaiyuk S., Al-Abadi E., Baildam E., Fotis L., Pain C., Pilkington C., Abulaban K., Barbar-Smiley F., Binstadt B., Bohnsack J., Boneparth A., Brown D., Chira P., Cron R., Dedeoglu F., Eberhard A., Gedalia A., Grom A., Henrickson M., Hom C., Huggins J., Jerath R., Jones J., Jung L., Kingsbury D., Lai J., Lovell D., Nanda K., Nocton J., Olson J., O’Neil K., Onel K., Punaro L., Reiff A., Rouster-Stevens K., Ruth N., Schikler K., Murphy Schmidt K., Schulert G., Shaham B., Singer N., Smith J., Sundel R., Syverson G., Vega-Fernandez P., Vehe R., Wagner-Weiner L., Cameto J., Jurado R., Maldonado I., the Paediatric Rheumatology International Trial Organisation and Pediatric Rheum
Publicada:
1 ene 2019
Categoría:
Rheumatology
Resumen:
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 (CRI c SLE ). Methods: Pediatric nephrology and rheumatology subspecialists (n = 213) experienced in cSLE management were invited to define CRI c SLE and rate a total of 433 unique patient profiles for the presence/absence of CRI c 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 CRI c 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 CRI c 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. © 2019, American College of Rheumatology
Filiaciones:
Brunner H.I.:
University of Cincinnati and Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
Holland M.J.:
University of Cincinnati and Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
Beresford M.W.:
Institute of Translational Medicine and Alder Hey Children’s NHS Foundation Trust, Liverpool, United Kingdom
Ardoin S.P.:
Ohio State University, Nationwide Children’s Hospital, and Wexner Medical Center, Columbus, OH, United States
Appenzeller S.:
University of Campinas, Campinas, Brazil
Silva C.A.:
Children’s Institute, Hospital das Clinicas HCFMUSP, Universidade de São Paulo, São Paulo, Brazil
Flores F.:
University of Cincinnati and Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
Goilav B.:
Children’s Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY, United States
Avar Aydin P.O.:
University of Cincinnati and Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
Wenderfer S.E.:
Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, United States
Levy D.M.:
University of Toronto and Hospital for Sick Children, Toronto, ON, Canada
Ravelli A.:
Clinica Pediatrica e Reumatologia, Istituto Giannina Gaslini, PRINTO, Genoa, Italy
Khubchandani R.:
Jaslok Hospital, Mumbai, India
Avcin T.:
University Children’s Hospital, University Medical Centre, Ljubljana, Slovenia
Klein-Gitelman M.S.:
Northwestern University Feinberg School of Medicine and Ann and Robert Lurie Children’s Hospital of Chicago, Chicago, IL, United States
Ruperto N.:
Clinica Pediatrica e Reumatologia, Istituto Giannina Gaslini, PRINTO, Genoa, Italy
Feldman B.M.:
University of Toronto and Hospital for Sick Children, Toronto, ON, Canada
Ying J.:
University of Cincinnati, Cincinnati, OH, United States
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