Real world treatment of juvenile-onset systemic lupus erythematosus: Data from the UK JSLE cohort study
Eve Smith, Naomi Egbivwie, Andrea Jorgensen, Coziana Ciurtin, Eslam Al‐Abadi, Kate Armon, Kathryn Bailey, Mary Brennan, Janet Gardner‐Medwin, Kirsty Haslam, Daniel Hawley, Alice Leahy, Valentina Leone, Gulshan Malik, Zoe McLaren, Clarissa Pilkington, Athimalaipet V Ramanan, Satyapal Rangaraj, Annie Ratcliffe, Phil Riley, Ethan S Sen, Arani Sridhar, Nick Wilkinson, Fiona Wood, Michael W. Beresford, Christian M. Hedrich
Abstract
BACKGROUND: In the absence of clinical trials evidence, Juvenile-onset Systemic Lupus Erythematosus (JSLE) treatment plans vary. AIM: To explore 'real world' treatment utilising longitudinal UK JSLE Cohort Study data. METHODS: Data collected between 07/2009-05/2020 was used to explore the choice/sequence of immunomodulating drugs from diagnosis. Multivariate logistic regression determined how organ-domain involvement (pBILAG-2004) impacted treatment choice. RESULT: < 0.01). Analyses assessing the sequence of immunomodulators focused on 197/349 patients (meeting relevant inclusion/exclusion criteria). 10/197 (5%) solely recieved hydroxychloroquine/prednisolone, 62/197 (31%) received a single-immunomodulator, 69/197 (36%) received two, and 36/197 patients (28%) received ≥three immunomodulators. The most common first and second line immunomodulator was MMF. Rituximab was the most common third-line immunomodulator. CONCLUSIONS: Most UK JSLE patients required ≥two immunomodulators, with MMF used most commonly.