Lupus & antiphospholipid syndrome
Validation of childhood lupus specific targets: ensuring accurate assessment of disease control in younger, lighter paediatric patients
Authors' conclusion
This study validates novel paediatric-specific targets, demonstrating that achieving cLLDAS, cCR and cCR-0 reduces risks of new damage and severe flare, which is comparable to aSLE targets.
Study context
- Population
- Childhood-onset SLE patients in the UK JSLE Cohort Study
- Participants
- 430 patients
- Exposure
- Attainment vs non-attainment of cSLE-specific targets (childhood lupus low disease activity state (cLLDAS), cCR, cCR-0), compared with aSLE targets (LLDAS, DORIS 2021 Remission)
- Outcome
- New damage and severe flare by target attainment
Methodological detailsvalidation study, UK JSLE Cohort Study, univariable and multivariable Prentice-Williams-Peterson (PWP) gap-time models
- Validation study
- UK JSLE Cohort Study
- Univariable and multivariable PWP gap-time models
Main finding
As reported in the abstract
Severe flare
Hazard ratio (95% CI)P value
cLLDAS
0.18(0.14–0.23)
all P < 0.001cCR
0.18(0.13–0.23)
all P < 0.001cCR-0
0.17(0.13–0.23)
all P < 0.001Observational data: associations, not effects.
Further findings
New damage
| HR (95% CI) | P value | ||
|---|---|---|---|
| cLLDASvs not attaining target | 0.22 (0.11–0.44) | all P < 0.001 | |
| cCRvs not attaining target | 0.25 (0.13–0.49) | all P < 0.001 | |
| cCR-0vs not attaining target | 0.30 (0.15–0.60) | all P < 0.001 | |
| 0.10.31310Hazard ratio (log scale) |
Inappropriate attainment of aSLE targets (on prednisolone doses precluding cSLE targets)
- LLDAS: visits
- 35
- LLDAS: median age (years)
- 7.3
- LLDAS: median weight (kg)
- 26.8
- LLDAS: median prednisolone dose, mg/kg/day (IQR 0.16-0.24)
- 0.17
- DORIS remission: visits
- 52
- DORIS remission: median age (years)
- 8.8
- DORIS remission: median weight (kg)
- 37.1
- DORIS remission: median prednisolone dose, mg/kg/day (IQR 0.11-0.16)
- 0.13
Original publication
Validation of childhood lupus specific targets: ensuring accurate assessment of disease control in younger, lighter paediatric patients. Rheumatology (Oxford). Published 6 February 2025. doi:10.
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