PMID- 28630236 OWN - NLM STAT- MEDLINE DCOM- 20171023 LR - 20211122 IS - 1468-2060 (Electronic) IS - 0003-4967 (Linking) VI - 76 IP - 11 DP - 2017 Nov TI - European evidence-based recommendations for diagnosis and treatment of childhood-onset systemic lupus erythematosus: the SHARE initiative. PG - 1788-1796 LID - 10.1136/annrheumdis-2016-210960 [doi] AB - Childhood-onset systemic lupus erythematosus (cSLE) is a rare, multisystem and potentially life-threatening autoimmune disorder with significant associated morbidity. Evidence-based guidelines are sparse and management is often based on clinical expertise. SHARE (Single Hub and Access point for paediatric Rheumatology in Europe) was launched to optimise and disseminate management regimens for children and young adults with rheumatic diseases like cSLE. Here, we provide evidence-based recommendations for diagnosis and treatment of cSLE. In view of extent and complexity of cSLE and its various manifestations, recommendations for lupus nephritis and antiphospholipid syndrome will be published separately. Recommendations were generated using the EULAR (European League Against Rheumatism) standard operating procedure. An expert committee consisting of paediatric rheumatologists and representation of paediatric nephrology from across Europe discussed evidence-based recommendations during two consensus meetings. Recommendations were accepted if >80% agreement was reached. A total of 25 recommendations regarding key approaches to diagnosis and treatment of cSLE were made. The recommendations include 11 on diagnosis, 9 on disease monitoring and 5 on general treatment. Topics included: appropriate use of SLE classification criteria, disease activity and damage indices; adequate assessment of autoantibody profiles; secondary macrophage activation syndrome; use of hydroxychloroquine and corticosteroid-sparing regimens; and the importance of addressing poor adherence. Ten recommendations were accepted regarding general diagnostic strategies and treatment indications of neuropsychiatric cSLE. The SHARE recommendations for cSLE and neuropsychiatric manifestations of cSLE have been formulated by an evidence-based consensus process to support uniform, high-quality standards of care for children with cSLE. CI - (c) Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. FAU - Groot, Noortje AU - Groot N AD - Wilhelmina Children's Hospital, Utrecht, Netherlands. AD - Sophia Children's Hospital, Erasmus University Medical Centre, Rotterdam, Netherlands. FAU - de Graeff, Nienke AU - de Graeff N AD - Wilhelmina Children's Hospital, Utrecht, Netherlands. FAU - Avcin, Tadej AU - Avcin T AD - University Children's Hospital Ljubljana, Ljubljana, Slovenia. FAU - Bader-Meunier, Brigitte AU - Bader-Meunier B AD - Necker Hospital, Assistance Publique-Hopitaux de Paris, Paris, France. FAU - Brogan, Paul AU - Brogan P AD - Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK. FAU - Dolezalova, Pavla AU - Dolezalova P AD - General University Hospital, First Faculty of Medicine, Charles University, Prague, Czech Republic. FAU - Feldman, Brian AU - Feldman B AD - The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. FAU - Kone-Paut, Isabelle AU - Kone-Paut I AD - Bicetre Hospital, APHP, University of Paris Sud, Paris, France. FAU - Lahdenne, Pekka AU - Lahdenne P AD - Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland. FAU - Marks, Stephen D AU - Marks SD AD - Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK. FAU - McCann, Liza AU - McCann L AD - Alder Hey Children's NHS Foundation Trust, Liverpool, UK. FAU - Ozen, Seza AU - Ozen S AD - Department of Pediatrics, Hacettepe University, Ankara, Turkey. FAU - Pilkington, Clarissa AU - Pilkington C AD - Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK. FAU - Ravelli, Angelo AU - Ravelli A AD - Universita degli Studi di Genova and Istituto Giannina Gaslini, Genoa, Italy. FAU - Royen-Kerkhof, Annet van AU - Royen-Kerkhof AV AD - Wilhelmina Children's Hospital, Utrecht, Netherlands. FAU - Uziel, Yosef AU - Uziel Y AD - Meir Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel. FAU - Vastert, Bas AU - Vastert B AD - Wilhelmina Children's Hospital, Utrecht, Netherlands. FAU - Wulffraat, Nico AU - Wulffraat N AD - Wilhelmina Children's Hospital, Utrecht, Netherlands. FAU - Kamphuis, Sylvia AU - Kamphuis S AD - Sophia Children's Hospital, Erasmus University Medical Centre, Rotterdam, Netherlands. FAU - Beresford, Michael W AU - Beresford MW AD - Alder Hey Children's NHS Foundation Trust, Liverpool, UK. AD - Institute of Translational Medicine, University of Liverpool, Liverpool, UK. LA - eng GR - 20417/ARC_/Arthritis Research UK/United Kingdom GR - 20747/ARC_/Arthritis Research UK/United Kingdom GR - MR/M01665X/1/MRC_/Medical Research Council/United Kingdom PT - Journal Article DEP - 20170619 PL - England TA - Ann Rheum Dis JT - Annals of the rheumatic diseases JID - 0372355 SB - IM MH - Adolescent MH - Age of Onset MH - Child MH - Europe MH - Evidence-Based Medicine/*standards MH - Humans MH - International Cooperation MH - Lupus Erythematosus, Systemic/*diagnosis/*therapy MH - *Practice Guidelines as Topic MH - Young Adult OTO - NOTNLM OT - Autoantibodies OT - Corticosteroids OT - Disease Activity OT - Systemic Lupus Erythematosus OT - Treatment COIS- Competing interests: None declared. EDAT- 2017/06/21 06:00 MHDA- 2017/10/24 06:00 CRDT- 2017/06/21 06:00 PHST- 2016/12/12 00:00 [received] PHST- 2017/05/02 00:00 [revised] PHST- 2017/05/04 00:00 [accepted] PHST- 2017/06/21 06:00 [pubmed] PHST- 2017/10/24 06:00 [medline] PHST- 2017/06/21 06:00 [entrez] AID - annrheumdis-2016-210960 [pii] AID - 10.1136/annrheumdis-2016-210960 [doi] PST - ppublish SO - Ann Rheum Dis. 2017 Nov;76(11):1788-1796. doi: 10.1136/annrheumdis-2016-210960. Epub 2017 Jun 19.