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Title: Treat-to-target in systemic lupus erythematosus: recommendations from an international task force.
Author: Van Vollenhoven, Ronald F.
Mosca, Marta
Bertsias, George
Isenberg, David
Kuhn, Annegret
Lerstrøm, Kirsten
Aringer, Martin
Bootsma, Hendrika
Boumpas, Dimitrios
Bruce, Ian N.
Cervera i Segura, Ricard, 1960-
Clarke, Ann E.
Costedoat-Chalumeau, Nathalie
Czirják, László
Derksen, R. H. W. M.
Dörner, Thomas
Gordon, Caroline
Graninger, Winfried
Houssiau, Frédéric A.
Inanc, Murat
Jacobsen, Søren
Jayne, David
Jedryka-Goral, Anna
Levitsky, Adrian
Levy, Roger A.
Mariette, Xavier
Morand, Eric
Navarra, Sandra
Neumann, Irmgard
Rahman, Anisur
Rovensky, J.
Smolen, Jozef
Vasconcelos, Carlos
Voskuyl, Alexandre E.
Voss, Anne
Zakharova, Helena
Zoma, Asad
Schneider, Matthias
Keywords: Lupus eritematós
Malalties autoimmunitàries
Salut pública
Estudi de casos
Lupus erythematosus
Autoimmune diseases
Public health
Case studies
Issue Date: 1-Jun-2014
Publisher: BMJ Publishing Group
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.
Note: Reproducció del document publicat a:
It is part of: Annals of the Rheumatic Diseases, 2014, vol. 73, num. 6, p. 958-967
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ISSN: 0003-4967
Appears in Collections:Articles publicats en revistes (Medicina)

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