ArticleArthritis care & research2018
American College of Rheumatology Provisional Criteria for Global Flares in Childhood-Onset Systemic Lupus Erythematosus.
Article in Arthritis care & research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Facilitating Expedited Drug Approval-the Past, Present, and Future of Clinical Trials for Pediatric Rheumatic Disease.Arthritis care & research · 2026Article
- New medicines for childhood-onset systemic lupus erythematosus: an EU perspective on paediatric drug development.Frontiers in medicine · 2025Article
- International Consensus for the Dosing of Corticosteroids in Childhood-Onset Systemic Lupus Erythematosus With Proliferative Lupus Nephritis.Arthritis & rheumatology (Hoboken, N.J.) · 2022Article
- An Update on the Management of Childhood-Onset Systemic Lupus Erythematosus.Paediatric drugs · 2021Review
- Outcome Scores in Pediatric Rheumatology.Current rheumatology reports · 2021Review
- The cytoskeletal regulator HEM1 governs B cell development and prevents autoimmunity.Science immunology · 2020Article
- Malar rash is a predictor of subclinical airway inflammation in patients with systemic lupus erythematosus: a pilot study.Clinical rheumatology · 2019Article
- American College of Rheumatology Provisional Criteria for Clinically Relevant Improvement in Children and Adolescents With Childhood-Onset Systemic Lupus Erythematosus.Arthritis care & research · 2019Article
- Use of "Provisional" Designation for Response Criteria.Arthritis care & research · 2018Article
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18 authors.
Funding
Abstract
objectiveTo validate the preliminary criteria of global flare for childhood-onset SLE (cSLE).
methodsPediatricians experienced in cSLE care (n = 268) rated unique patient profiles; results of standard cSLE laboratory testing and information about the cSLE flare descriptors were presented as follows: global assessment of patient well-being, physician global assessment of disease activity (MD-global), Disease Activity Index score, protein/creatinine ratio (PCR), and erythrocyte sedimentation rate (ESR). Using rater interpretation of the course of cSLE (baseline versus followup as the gold standard), performance (sensitivity, specificity, area under the receiver operating characteristic curve [AUC]) of the preliminary flare criteria was tested. An international consensus conference was held to rank the preliminary flare criteria as per the American College of Rheumatology recommendations and delineate threshold scores for minor, moderate, and major flares.
resultsThe accuracy of the 2 highest-ranked candidate criteria that consider absolute changes (∆) of the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) or British Isles Lupus Assessment Group (BILAG) (numeric scoring: A = 12, B = 8, C = 1, and D/E = 0), MD-global, PCR, and ESR were confirmed (both AUC >0.93). For the SLEDAI-based criteria (0.5 × ∆SLEDAI + 0.45 × ∆PCR + 0.5 × ∆MD-global + 0.02 × ∆ESR) flare scores ≥6.4/3.0/0.6 constituted major/moderate/minor flares, respectively. For the BILAG-based algorithm (0.4 × ∆BILAG + 0.65 × ∆PCR + 0.5 × ∆MD-global + 0.02 × ∆ESR) flare scores ≥7.4/3.7/2.2 delineated major/moderator/minor flares, respectively. These threshold values (SLEDAI, BILAG) were all >82% sensitive and specific for capturing flare severity.
conclusionProvisional criteria for global flares in cSLE are available to identify patients who experienced a flare. These criteria also allow for discrimination of the severity of cSLE exacerbations.
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