title: An update on childhood-onset systemic lupus erythematosus.
abstract: OBJECTIVE
  This manuscript will provide a review of studies published in the last year examining the major disease manifestations, comorbidities, biomarkers and therapeutic trials involving childhood-onset systemic lupus erythematosus (cSLE) patients.
  
  
  RESULTS
  Recent multicenter prospective cohort studies supported previous findings that cSLE patients accrue damage early on their disease. Four studies showed that ethnicity altered disease severity and incidence of both cSLE and lupus nephritis. Description of clinical features and response to therapy in a large group of cSLE patients with neuropsychiatric involvement provided useful information on this feature. Advancement in the field of biomarkers was seen but the new biomarkers are not yet ready for clinical use. A randomized placebo-controlled trial of statins to prevent atherosclerosis progression did not meet its primary endpoint but did show a trend in improvement of carotid intima-media thickness, a surrogate marker of atherosclerosis. No other prospective interventional treatment trials designed specifically for cSLE patients were reported in the past year.
  
  
  CONCLUSIONS
  There is an urgent need to better characterize the long-term outcome of cSLE patients and identify early on those at risk of a worse outcome. Advances in the field of biologics and small molecules will hopefully allow better targeted therapies of the cSLE population.
authors.affiliation: Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. julie.barsalou@sickkids.ca
authors.forename: Julie
authors.initials: J
authors.lastname: Barsalou
authors.forename: Deborah M
authors.initials: DM
authors.lastname: Levy
authors.forename: Earl D
authors.initials: ED
authors.lastname: Silverman
mesh_terms: D017668:Age of Onset; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000209:etiology; D002648:Child; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000208:ethnology; D008181:Lupus Nephritis / Q000208:ethnology; D020945:Lupus Vasculitis, Central Nervous System / Q000175:diagnosis / Q000523:psychology; D001523:Mental Disorders / Q000209:etiology; D010024:Osteoporosis / Q000209:etiology; D015995:Prevalence; D011379:Prognosis
chemical_list: D015415:Biomarkers