title: Consensus treatment plans for induction therapy of newly diagnosed proliferative lupus nephritis in juvenile systemic lupus erythematosus.
abstract: OBJECTIVE
  To formulate consensus treatment plans (CTPs) for induction therapy of newly diagnosed proliferative lupus nephritis (LN) in juvenile systemic lupus erythematosus (SLE).
  
  
  METHODS
  A structured consensus formation process was employed by the members of the Childhood Arthritis and Rheumatology Research Alliance after considering the existing medical evidence and current treatment approaches.
  
  
  RESULTS
  After an initial Delphi survey (response rate = 70%), a 2-day consensus conference, and 2 followup Delphi surveys (response rates = 63-79%), consensus was achieved for a limited set of CTPs addressing the induction therapy of proliferative LN. These CTPs were developed for prototypical patients defined by eligibility characteristics, and included immunosuppressive therapy with either mycophenolic acid orally twice per day, or intravenous cyclophosphamide once per month at standardized dosages for 6 months. Additionally, the CTPs describe 3 options for standardized use of glucocorticoids, including a primarily oral, a mixed oral/intravenous, and a primarily intravenous regimen. There was consensus on measures of effectiveness and safety of the CTPs. The CTPs were well accepted by the pediatric rheumatology providers treating children with LN, and up to 300 children per year in North America are expected to be candidates for the treatment with the CTPs.
  
  
  CONCLUSIONS
  CTPs for induction therapy of proliferative LN in juvenile SLE based on the available scientific evidence and pediatric rheumatology group experience have been developed. Consistent use of the CTPs may improve the prognosis of proliferative LN, and support the conduct of comparative effectiveness studies aimed at optimizing therapeutic strategies for proliferative LN in juvenile SLE.
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
authors.forename: Rina
authors.initials: R
authors.lastname: Mina
authors.forename: Emily
authors.initials: E
authors.lastname: von Scheven
authors.forename: Stacy P
authors.initials: SP
authors.lastname: Ardoin
authors.forename: B Anne
authors.initials: BA
authors.lastname: Eberhard
authors.forename: Marilynn
authors.initials: M
authors.lastname: Punaro
authors.forename: Norman
authors.initials: N
authors.lastname: Ilowite
authors.forename: Joyce
authors.initials: J
authors.lastname: Hsu
authors.forename: Marisa
authors.initials: M
authors.lastname: Klein-Gitelman
authors.forename: L Nandini
authors.initials: LN
authors.lastname: Moorthy
authors.forename: Eyal
authors.initials: E
authors.lastname: Muscal
authors.forename: Suhas M
authors.initials: SM
authors.lastname: Radhakrishna
authors.forename: Linda
authors.initials: L
authors.lastname: Wagner-Weiner
authors.forename: Matthew
authors.initials: M
authors.lastname: Adams
authors.forename: Peter
authors.initials: P
authors.lastname: Blier
authors.forename: Lenore
authors.initials: L
authors.lastname: Buckley
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Chalom
authors.forename: Gaëlle
authors.initials: G
authors.lastname: Chédeville
authors.forename: Andrew
authors.initials: A
authors.lastname: Eichenfield
authors.forename: Natalya
authors.initials: N
authors.lastname: Fish
authors.forename: Michael
authors.initials: M
authors.lastname: Henrickson
authors.forename: Aimee O
authors.initials: AO
authors.lastname: Hersh
authors.forename: Roger
authors.initials: R
authors.lastname: Hollister
authors.forename: Olcay
authors.initials: O
authors.lastname: Jones
authors.forename: Lawrence
authors.initials: L
authors.lastname: Jung
authors.forename: Deborah
authors.initials: D
authors.lastname: Levy
authors.forename: Jorge
authors.initials: J
authors.lastname: Lopez-Benitez
authors.forename: Deborah
authors.initials: D
authors.lastname: McCurdy
authors.forename: Paivi M
authors.initials: PM
authors.lastname: Miettunen
authors.forename: Ana I
authors.initials: AI
authors.lastname: Quintero-del Rio
authors.forename: Deborah
authors.initials: D
authors.lastname: Rothman
authors.forename: Ornella
authors.initials: O
authors.lastname: Rullo
authors.forename: Natasha
authors.initials: N
authors.lastname: Ruth
authors.forename: Laura E
authors.initials: LE
authors.lastname: Schanberg
authors.forename: Earl
authors.initials: E
authors.lastname: Silverman
authors.forename: Nora G
authors.initials: NG
authors.lastname: Singer
authors.forename: Jennifer
authors.initials: J
authors.lastname: Soep
authors.forename: Reema
authors.initials: R
authors.lastname: Syed
authors.forename: Larry B
authors.initials: LB
authors.lastname: Vogler
authors.forename: Ali
authors.initials: A
authors.lastname: Yalcindag
authors.forename: Cagri
authors.initials: C
authors.lastname: Yildirim-Toruner
authors.forename: Carol A
authors.initials: CA
authors.lastname: Wallace
authors.forename: Hermine I
authors.initials: HI
authors.lastname: Brunner
mesh_terms: D002648:Child; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy*; D008181:Lupus Nephritis / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D012074:Remission Induction / Q000379:methods*
chemical_list: D007166:Immunosuppressive Agents