Framework for implementing treat-to-target in systemic lupus erythematosus routine clinical care: consensus...

Area of Science:

• Rheumatology
• Clinical Practice Guidelines
• Systemic Lupus Erythematosus Research

Background:

• Treat-to-Target (T2T) implementation in systemic lupus erythematosus (SLE) clinical practice is notably low.
• Real-world evidence indicates excessive glucocorticoid (GC) use and suboptimal disease control in SLE patients.
• Existing T2T recommendations for SLE lack a practical framework for routine clinical application.

Purpose of the Study:

• To develop a consensus framework for implementing Treat-to-Target (T2T) in the routine clinical care of adult patients with SLE.
• To provide actionable strategies for physicians to enhance SLE management through T2T principles.
• To address challenges and propose future research directions for T2T in SLE.

Main Methods:

• An international task force of 22 SLE physicians and 3 lupus patient research partners was convened.
• A scoping review of T2T definitions and instruments for SLE was conducted, followed by online discussions.
• A Delphi consensus process was used to develop and agree upon framework statements for T2T implementation in SLE.

Main Results:

• The developed framework includes 5 overarching principles and 11 actionable statements for T2T implementation in SLE.
• The framework aims to bridge the gap between T2T recommendations and real-world clinical practice.
• Analysis identified current barriers to T2T adoption and areas for future research in SLE management.

Conclusions:

• A consensus framework for implementing Treat-to-Target (T2T) in SLE has been established to guide clinical practice.
• This framework provides a real-world perspective to improve SLE patient outcomes by optimizing disease management.
• The initiative seeks to inform a broader range of healthcare providers, including non-specialists, about effective T2T strategies in SLE.