Gotch, Ruby;
Ahmed, Yumna;
Wilson, Robert;
Hawkins, Ellie;
Ciurtin, Coziana;
(2024)
Active implementation of low disease activity state as a treatment
endpoint in childhood‑onset systemic lupus erythematosus in routine
practice is both feasible and associated with better outcomes.
Clinical Rheumatology
, 43
pp. 3231-3238.
10.1007/s10067-024-07101-4.
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Abstract
Introduction: Treat-to-target (T2T) strategies aim to facilitate tight disease control to improve outcomes. No previous studies evaluated prospectively the feasibility and impact of the T2T strategy in routine practice in childhood-onset SLE (cSLE). Methods: Adolescents and young adults (AYA) with cSLE were recruited for T2T implementation from a large tertiary centre over a period of 6 months and followed up at least twice over a prospective period of 12 months. Results: During Oct 2022–April 2023, 135/162 (83.3%) AYA with cSLE had disease scores evaluated at their routine appointment to enable inclusion in the study, and 122/135 (91.2%) had their disease assessed, and a suitable treatment target agreed and documented at each routine clinical appointment over the 12 months prospective follow-up. T2T strategy led to improved disease control at 12 months: more AYA with cSLE achieved clinical remission of steroids (4.1% vs. 10.7%, P=0.048), or minimum childhood-lupus low disease activity (cLLDAS) (81.9% vs. 91.8%, P=0.022). Achieving minimum cLLDAS for longer than 3 months was associated with reduced damage accrual (HR=1.7; 95%CI=1.1–2.5; P<0.0001) at 12 months. Conclusion: T2T strategy implementation was achievable and associated with improved cSLE control. Spending at least 3/12 months in cLLDAS led to less damage accumulation.
| Type: | Article |
|---|---|
| Title: | Active implementation of low disease activity state as a treatment endpoint in childhood‑onset systemic lupus erythematosus in routine practice is both feasible and associated with better outcomes |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1007/s10067-024-07101-4 |
| Publisher version: | https://doi.org/10.1007/s10067-024-07101-4 |
| Language: | English |
| Additional information: | This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
| Keywords: | Childhood-lupus low disease activity — cLLDAS; Childhood-onset systemic lupus erythematosus — cSLE; Feasibility study; Treat to target — T2T |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10196247 |
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