Real world treatment of juvenile-onset systemic lupus erythematosus: Data from the UK JSLE cohort study

Smith, E. M. D. et al. (2022) Real world treatment of juvenile-onset systemic lupus erythematosus: Data from the UK JSLE cohort study. Clinical Immunology, 239, 109028. (doi: 10.1016/j.clim.2022.109028) (PMID:35513304)

Abstract

Background: In the absence of clinical trials evidence, Juvenile-onset Systemic Lupus Erythematosus (JSLE) treatment plans vary. Aim: To explore ‘real world’ treatment utilising longitudinal UK JSLE Cohort Study data. Methods: Data collected between 07/2009–05/2020 was used to explore the choice/sequence of immunomodulating drugs from diagnosis. Multivariate logistic regression determined how organ-domain involvement (pBILAG-2004) impacted treatment choice. Result: 349 patients met inclusion criteria, median follow-up 4-years (IQR:2,6). Mycophenolate mofetil (MMF) was most commonly used for the majority of organ-domains, and significantly associated with renal involvement (OR:1.99, 95% CI:1.65–2.41, pc < 0.01). Analyses assessing the sequence of immunomodulators focused on 197/349 patients (meeting relevant inclusion/exclusion criteria). 10/197 (5%) solely recieved hydroxychloroquine/prednisolone, 62/197 (31%) received a single-immunomodulator, 69/197 (36%) received two, and 36/197 patients (28%) received ≥three immunomodulators. The most common first and second line immunomodulator was MMF. Rituximab was the most common third-line immunomodulator. Conclusions: Most UK JSLE patients required ≥two immunomodulators, with MMF used most commonly.

• Item Type: Articles
• Additional Information: Funding support: Lupus UK provide financial support for co-ordination of the UK JSLE Cohort Study [grant numbers: LUPUS UK: JXR10500, JXR12309]. The study took place as part of the UK’s ‘Experimental Arthritis Treatment Centre for Children’ supported by Versus Arthritis (grant number ARUK20621; VA-22663), the University of Liverpool, Alder Hey Children’s NHS Foundation Trust and the Alder Hey Charity, and based at the University of Liverpool and Alder Hey Children’s NHS Foundation Trust.
• Keywords: Treatment, SLE, Juvenile-onset SLE, Childhood, Immunosuppression
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Gardner-Medwin, Dr Janet
• Authors: Smith, E. M. D., Egbivwie, N., Jorgensen, A. L., Ciurtin, C., Al-Abadi, E., Armon, K., Bailey, K., Brennan, M., Gardner-Medwin, J., Haslam, K., Hawley, D. P., Leahy, A., Leone, V., Malik, G., McLaren, Z., Pilkington, C., Ramanan, A. V., Rangaraj, S., Ratcliffe, A., Riley, P., Sen, E., Sridhar, A., Wilkinson, N., Wood, F., Beresford, M. W., and Hedrich, C. M.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Clinical Immunology
• Publisher: Elsevier
• ISSN: 1521-6616
• ISSN (Online): 1521-7035
• Published Online: 02 May 2022
• Copyright Holders: Copyright © 2022 The Authors
• First Published: First published in Clinical Immunology 239: 109028
• Publisher Policy: Reproduced under a Creative Commons License