PReS-endorsed international childhood lupus T2T task force definition of childhood lupus low disease activity state (cLLDAS)

To achieve a consensus-based definition of Low Disease Activity (LDA) for use in cSLE trials. The International cSLE T2T Task Force, comprising of paediatric rheumatologists/nephrologists, and adult rheumatologists undertook a series of Delphi surveys/consensus meetings to discuss, refine, and vote upon cSLE LDA criteria. The Task Force agreed that LDA should be based upon the adult-SLE Lupus Low Disease Activity State definition (LLDAS), with modifications to make it applicable to cSLE (cLLDAS). They agreed upon five cLLDAS criteria: (1) SLE Disease Activity Index (SLEDAI)-2 K ≤4, with no activity in major organ systems; (2) no new features of lupus disease activity compared with the last assessment; (3) Physician Global Assessment score of ≤1 (0–3 scale); (4) prednisolone dose of ≤0.15 mg/kg/day, 7.5 mg/day/maximum; while on (5) stable antimalarials, immunosuppressives, and biologics. A cSLE-appropriate definition of cLLDAS has been generated, maintaining alignment with the adult-SLE definition to promote life-course research. •What is already known on this topic LLDAS has been extensively investigated in SLE, until now, a cSLE definition has been lacking.•What this study adds The cSLE T2T Task Force have derived a cSLE appropriate definition; childhood LLDAS.•How this study might affect research, practice or policy - The cLLDAS definition will facilitate the development of future T2T approaches.