Evidence mapPaperPMID 36627168Full record

SynthesisAnnals of the rheumatic diseases2023

Towards development of treat to target (T2T) in childhood-onset systemic lupus erythematosus: PReS-endorsed overarching principles and points-to-consider from an international task force.

Eve Mary Dorothy Smith, Amita Aggarwal, Jenny Ainsworth, Eslam Al-Abadi, Tadej Avcin, Lynette Bortey, Jon Burnham, Coziana Ciurtin, Christian M Hedrich, Sylvia Kamphuis and 14 more

Open access · hybridAbstract readSystematic Review
In one paragraph

Synthesis in Annals of the rheumatic diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 4 pooled it
10.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

26 citing papers in PubMed, 4 syntheses or guidelines pooled it, 41 citations in OpenAlex.

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  19. New Insights on Childhood Lupus Nephritis.International journal of nephrology and renovascular disease · 2025
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors at 16 institutions in 12 countries.

Eve Mary Dorothy SmithDepartment of Women's & Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool Faculty of Health and Life Sciences, Liverpool, UK esmith8@liverpool.ac.uk.ORCID 0000-0002-8371-7597
Amita AggarwalDepartment of Clinical Immunology & Rheumatology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.ORCID 0000-0002-2187-5186
Jenny AinsworthDepartment of Women's & Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool Faculty of Health and Life Sciences, Liverpool, UK.
Eslam Al-AbadiDepartment of Paediatric Rheumatology, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK.ORCID 0000-0002-1999-6341
Tadej AvcinDepartment of Pediatric Rheumatology and Clinical Immunology, University Medical Centre Ljubljana Division of Paediatrics, Ljubljana, Slovenia.
Lynette BorteyTARGET Lupus Public Patient Involvement and Engagement Group, University of Liverpool Faculty of Health and Life Sciences, Liverpool, UK.
Jon BurnhamDepartment of Pediatric Rheumatology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Coziana CiurtinCentre for Adolescent Rheumatology Versus Arthritis, Division of Medicine, University College London, London, UK.ORCID 0000-0002-8911-4113
Christian M HedrichDepartment of Women's & Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool Faculty of Health and Life Sciences, Liverpool, UK.
Sylvia KamphuisDepartment of Paediatric Rheumatology, Erasmus Medical Center, Rotterdam, The Netherlands.
Deborah M LevyDepartment of Pediatric Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada.
Laura B LewandowskiNational Institutes of Health, National Institute of Arthritis and Musculoskeletal and Skin Diseases Systemic Autoimmunity Branch, Bethesda, Maryland, USA.
Naomi MaxwellTARGET Lupus Public Patient Involvement and Engagement Group, University of Liverpool Faculty of Health and Life Sciences, Liverpool, UK.
Eric F MorandDepartment of Rheumatology, Monash University, Clayton, Victoria, Australia.ORCID 0000-0002-9507-3338
Seza OzenDepartment of Pediatrics, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Clare E PainDepartment of Women's & Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool Faculty of Health and Life Sciences, Liverpool, UK.
Angelo RavelliDirezione Scientifica, Istituto Giannina Gaslini Istituto Pediatrico di Ricovero e Cura a Carattere Scientifico, Genova, Liguria, Italy.ORCID 0000-0001-9658-0385
Claudia Saad MagalhaesDepartment of Pediatric Rheumatology, Botucatu Medical School, Sao Paulo University Faculty of Medicine, Sao Paulo, Brazil.
Clarissa A PilkingtonDepartment of Paediatric Rheumatology, Great Ormond Street Hospital for Children, London, UK.
Dieneke Schonenberg-MeinemaDepartment of Pediatric Immunology, Rheumatology and Infectious Diseases, University of Amsterdam, Amsterdam, The Netherlands.
Christiaan ScottDepartment of Paediatric Rheumatology, University of Cape Town, Rondebosch, Western Cape, South Africa.
Kjell TullusDepartment of Paediatric Nephrology, Great Ormond Street Hospital for Children, London, UK.
Michael William BeresfordDepartment of Women's & Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool Faculty of Health and Life Sciences, Liverpool, UK.ORCID 0000-0002-5400-9911
cSLE T2T International Task Force
University of Liverpool · GBGreat Ormond Street Hospital · GBArthritis UK · GBAustralian Regenerative Medicine Institute · AUBirmingham Children's Hospital · GBCenter for Rheumatology · USChildren's Hospital of Philadelphia · USEmma Kinderziekenhuis · NLErasmus MC · NLIstituto Giannina Gaslini · ITLjubljana University Medical Centre · SINational Institutes of Health · USSanjay Gandhi Post Graduate Institute of Medical Sciences · INUniversidade de São Paulo · BRUniversity of Cape Town · ZAUniversity of Toronto · CA

Funding

Genetics and pathophysiology of systemic lupus erythematosus in global populationsZIAAR041214 · NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES · 2025 to 2025
$981k
Medical Research Council MR/R013926/1Versus Arthritis 22203Versus Arthritis 22908Wellcome Trust
6 · The paper itself

Abstract

objectivesApplication of 'treat-to-target' (T2T) in childhood-onset systemic lupus erythematosus (cSLE) may improve care and health outcomes. This initiative aimed to harmonise existing evidence and expert opinion regarding T2T for cSLE.

methodsAn international T2T Task Force was formed of specialists in paediatric rheumatology, paediatric nephrology, adult rheumatology, patient and parent representatives. A steering committee formulated a set of draft overarching principles and points-to-consider, based on evidence from systematic literature review. Two on-line preconsensus meeting Delphi surveys explored healthcare professionals' views on these provisional overarching principles and points-to-consider. A virtual consensus meeting employed a modified nominal group technique to discuss, modify and vote on each overarching principle/point-to-consider. Agreement of >80% of Task Force members was considered consensus.

resultsThe Task Force agreed on four overarching principles and fourteen points-to-consider. It was agreed that both treatment targets and therapeutic strategies should be subject to shared decision making with the patient/caregivers, with full remission the preferred target, and low disease activity acceptable where remission cannot be achieved. Important elements of the points-to-consider included: aiming for prevention of flare and organ damage; glucocorticoid sparing; proactively addressing factors that impact health-related quality of life (fatigue, pain, mental health, educational challenges, medication side effects); and aiming for maintenance of the target over the long-term. An extensive research agenda was also formulated.

conclusionsThese international, consensus agreed overarching principles and points-to-consider for T2T in cSLE lay the foundation for future T2T approaches in cSLE, endorsed by the Paediatric Rheumatology European Society.

Indexed as

Lupus Erythematosus, SystemicQuality of LifeAdultAdvisory CommitteesChildHumansRemission InductionSurveys and QuestionnairesAutoimmune DiseasesGlucocorticoidsHealth services researchLupus Erythematosus, SystemicOutcome and Process Assessment, Health Care

Identifiers

PMID36627168
PMCPMC10314055
OpenAlexW4315475349

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.