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. 2012 Mar;64(3):375-83.
doi: 10.1002/acr.21558.

Consensus treatment plans for induction therapy of newly diagnosed proliferative lupus nephritis in juvenile systemic lupus erythematosus

Rina Mina  1 , Emily von Scheven, Stacy P Ardoin, B Anne Eberhard, Marilynn Punaro, Norman Ilowite, Joyce Hsu, Marisa Klein-Gitelman, L Nandini Moorthy, Eyal Muscal, Suhas M Radhakrishna, Linda Wagner-Weiner, Matthew Adams, Peter Blier, Lenore Buckley, Elizabeth Chalom, Gaëlle Chédeville, Andrew Eichenfield, Natalya Fish, Michael Henrickson, Aimee O Hersh, Roger Hollister, Olcay Jones, Lawrence Jung, Deborah Levy, Jorge Lopez-Benitez, Deborah McCurdy, Paivi M Miettunen, Ana I Quintero-del Rio, Deborah Rothman, Ornella Rullo, Natasha Ruth, Laura E Schanberg, Earl Silverman, Nora G Singer, Jennifer Soep, Reema Syed, Larry B Vogler, Ali Yalcindag, Cagri Yildirim-Toruner, Carol A Wallace, Hermine I Brunner; Carra SLE Subcommittee
Affiliations

Consensus treatment plans for induction therapy of newly diagnosed proliferative lupus nephritis in juvenile systemic lupus erythematosus

Rina Mina et al. Arthritis Care Res (Hoboken). 2012 Mar.

Abstract

Objective: To formulate consensus treatment plans (CTPs) for induction therapy of newly diagnosed proliferative lupus nephritis (LN) in juvenile systemic lupus erythematosus (SLE).

Methods: A structured consensus formation process was employed by the members of the Childhood Arthritis and Rheumatology Research Alliance after considering the existing medical evidence and current treatment approaches.

Results: After an initial Delphi survey (response rate = 70%), a 2-day consensus conference, and 2 followup Delphi surveys (response rates = 63-79%), consensus was achieved for a limited set of CTPs addressing the induction therapy of proliferative LN. These CTPs were developed for prototypical patients defined by eligibility characteristics, and included immunosuppressive therapy with either mycophenolic acid orally twice per day, or intravenous cyclophosphamide once per month at standardized dosages for 6 months. Additionally, the CTPs describe 3 options for standardized use of glucocorticoids, including a primarily oral, a mixed oral/intravenous, and a primarily intravenous regimen. There was consensus on measures of effectiveness and safety of the CTPs. The CTPs were well accepted by the pediatric rheumatology providers treating children with LN, and up to 300 children per year in North America are expected to be candidates for the treatment with the CTPs.

Conclusion: CTPs for induction therapy of proliferative LN in juvenile SLE based on the available scientific evidence and pediatric rheumatology group experience have been developed. Consistent use of the CTPs may improve the prognosis of proliferative LN, and support the conduct of comparative effectiveness studies aimed at optimizing therapeutic strategies for proliferative LN in juvenile SLE.

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Conflict of interest statement

There is no other existing or perceived conflict of interest of any of the authors.

Figures

Figure 1
Figure 1
The development of the Consensus Treatment Plans for proliferative lupus nephritis (jLN) in juvenile SLE based on consensus-formation techniques
Figure 2
Figure 2
Modified nominal group process used to achieve consensus
Figure 3
Figure 3
Consensus Treatment Plans for proliferative jLN
See this image and copyright information in PMC

References

    1. Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1997 Sep;40(9):1725. - PubMed
    1. Mina R, Brunner HI. Pediatric lupus--are there differences in presentation, genetics, response to therapy, and damage accrual compared with adult lupus? Rheum Dis Clin North Am. 2010 Feb;36(1):53–80. vii-viii. - PMC - PubMed
    1. Marks SD, Sebire NJ, Pilkington C, Tullus K. Clinicopathological correlations of paediatric lupus nephritis. Pediatr Nephrol. 2007 Jan;22(1):77–83. - PubMed
    1. Weening JJ, D'Agati VD, Schwartz MM, et al. The classification of glomerulonephritis in systemic lupus erythematosus revisited. J Am Soc Nephrol. 2004 Feb;15(2):241–250. - PubMed
    1. Lupus nephritis: prognostic factors and probability of maintaining life-supporting renal function 10 years after the diagnosis. Gruppo Italiano per lo Studio della Nefrite Lupica (GISNEL) Am J Kidney Dis. 1992 May;19(5):473–479. - PubMed

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