Treat-to-target in systemic lupus erythematosus: recommendations from an international task force

Research output: Contribution to journalArticlepeer-review

Authors

  • Ronald F van Vollenhoven
  • Marta Mosca
  • George Bertsias
  • David Isenberg
  • Annegret Kuhn
  • Kirsten Lerstrøm
  • Martin Aringer
  • Hendrika Bootsma
  • Dimitrios Boumpas
  • Ian N Bruce
  • Ricard Cervera
  • Ann Clarke
  • Nathalie Costedoat-Chalumeau
  • László Czirják
  • Ronald Derksen
  • Thomas Dörner
  • Winfried Graninger
  • Frédéric Houssiau
  • Murat Inanc
  • Søren Jacobsen
  • David Jayne
  • Anna Jedryka-Goral
  • Adrian Levitsky
  • Roger Levy
  • Xavier Mariette
  • Eric Morand
  • Sandra Navarra
  • Irmgard Neumann
  • Anisur Rahman
  • Jozef Rovensky
  • Josef Smolen
  • Carlos Vasconcelos
  • Alexandre Voskuyl
  • Anne Voss
  • Helena Zakharova
  • Asad Zoma
  • Matthias Schneider

Colleges, School and Institutes

External organisations

  • Department of Medicine, Unit for Clinical Therapy Research, Inflammatory Diseases, Stockholm, Sweden, Karolinska Institutet, Stockholm, Sweden.

Abstract

The principle of treating-to-target has been successfully applied to many diseases outside rheumatology and more recently to rheumatoid arthritis. Identifying appropriate therapeutic targets and pursuing these systematically has led to improved care for patients with these diseases and useful guidance for healthcare providers and administrators. Thus, an initiative to evaluate possible therapeutic targets and develop treat-to-target guidance was believed to be highly appropriate in the management of systemic lupus erythematosus (SLE) patients as well. Specialists in rheumatology, nephrology, dermatology, internal medicine and clinical immunology, and a patient representative, contributed to this initiative. The majority convened on three occasions in 2012-2013. Twelve topics of critical importance were identified and a systematic literature review was performed. The results were condensed and reformulated as recommendations, discussed, modified and voted upon. The finalised bullet points were analysed for degree of agreement among the task force. The Oxford Centre level of evidence (LoE, corresponding to the research questions) and grade of recommendation (GoR) were determined for each recommendation. The 12 systematic literature searches and their summaries led to 11 recommendations. Prominent features of these recommendations are targeting remission, preventing damage and improving quality of life. LoE and GoR of the recommendations were variable but agreement was >0.9 in each case. An extensive research agenda was identified, and four overarching principles were also agreed upon. Treat-to-target-in-SLE (T2T/SLE) recommendations were developed by a large task force of multispecialty experts and a patient representative. It is anticipated that 'treating-to-target' can and will be applicable to the care of patients with SLE.

Details

Original languageEnglish
JournalAnnals of the Rheumatic Diseases
Publication statusPublished - 16 Apr 2014