title: Treat-to-target in systemic lupus erythematosus: recommendations from an international task force.
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.
authors.affiliation: Department of Medicine, Unit for Clinical Therapy Research, Inflammatory Diseases, Stockholm, Sweden, Karolinska Institutet, , Stockholm, Sweden.
authors.forename: Ronald F
authors.initials: RF
authors.lastname: van Vollenhoven
authors.forename: Marta
authors.initials: M
authors.lastname: Mosca
authors.forename: George
authors.initials: G
authors.lastname: Bertsias
authors.forename: David
authors.initials: D
authors.lastname: Isenberg
authors.forename: Annegret
authors.initials: A
authors.lastname: Kuhn
authors.forename: Kirsten
authors.initials: K
authors.lastname: Lerstrøm
authors.forename: Martin
authors.initials: M
authors.lastname: Aringer
authors.forename: Hendrika
authors.initials: H
authors.lastname: Bootsma
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Boumpas
authors.forename: Ian N
authors.initials: IN
authors.lastname: Bruce
authors.forename: Ricard
authors.initials: R
authors.lastname: Cervera
authors.forename: Ann
authors.initials: A
authors.lastname: Clarke
authors.forename: Nathalie
authors.initials: N
authors.lastname: Costedoat-Chalumeau
authors.forename: László
authors.initials: L
authors.lastname: Czirják
authors.forename: Ronald
authors.initials: R
authors.lastname: Derksen
authors.forename: Thomas
authors.initials: T
authors.lastname: Dörner
authors.forename: Caroline
authors.initials: C
authors.lastname: Gordon
authors.forename: Winfried
authors.initials: W
authors.lastname: Graninger
authors.forename: Frédéric
authors.initials: F
authors.lastname: Houssiau
authors.forename: Murat
authors.initials: M
authors.lastname: Inanc
authors.forename: Søren
authors.initials: S
authors.lastname: Jacobsen
authors.forename: David
authors.initials: D
authors.lastname: Jayne
authors.forename: Anna
authors.initials: A
authors.lastname: Jedryka-Goral
authors.forename: Adrian
authors.initials: A
authors.lastname: Levitsky
authors.forename: Roger
authors.initials: R
authors.lastname: Levy
authors.forename: Xavier
authors.initials: X
authors.lastname: Mariette
authors.forename: Eric
authors.initials: E
authors.lastname: Morand
authors.forename: Sandra
authors.initials: S
authors.lastname: Navarra
authors.forename: Irmgard
authors.initials: I
authors.lastname: Neumann
authors.forename: Anisur
authors.initials: A
authors.lastname: Rahman
authors.forename: Jozef
authors.initials: J
authors.lastname: Rovensky
authors.forename: Josef
authors.initials: J
authors.lastname: Smolen
authors.forename: Carlos
authors.initials: C
authors.lastname: Vasconcelos
authors.forename: Alexandre
authors.initials: A
authors.lastname: Voskuyl
authors.forename: Anne
authors.initials: A
authors.lastname: Voss
authors.forename: Helena
authors.initials: H
authors.lastname: Zakharova
authors.forename: Asad
authors.initials: A
authors.lastname: Zoma
authors.forename: Matthias
authors.initials: M
authors.lastname: Schneider
mesh_terms: D026683:Advisory Committees; D019468:Disease Management; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000628:therapy*; D010347:Patient Care Planning; D012074:Remission Induction / Q000379:methods; D055502:Secondary Prevention / Q000379:methods
keywords: Patient perspective; Systemic Lupus Erythematosus; Treatment