The multisystem involvement and variable course of juvenile-onset systemic lupus erythematosus (JSLE) make it difficult to assess disease activity. Researchers reviewed a large national cohort of juveniles with SLE in the UK to assess the proposed definition for clinical remission or inactive disease (ID), which is critical to treatment and trials. The majority of people in the cohort failed to meet the proposed criteria for ID. Most required immunosuppressive treatment, reflecting the high burden of disease in JSLE despite therapy. The study indicates misalignment of clinically important disease activity. In a clinical setting, the proposed criteria for ID overestimated the percentage of patients with active disease. The researchers concluded that a ‘treat to target’ approach of more aggressive management should be considered in future clinical studies/trials to determine if this can improve outcomes. This will ultimately support consensus for a definition of inactive disease. Learn about lupus remission.

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