European evidence-based recommendations for diagnosis and treatment of paediatric antiphospholipid syndrome: The SHARE initiative
Groot, Noortje; De Graeff, Nienke; Avcin, Tadej; Bader-Meunier, Brigitte; Dolezalova, Pavla; Feldman, Brian M.; Kenet, Gili; Koné-Paut, Isabelle; Lahdenne, Pekka; Marks, Stephen D; McCann, Liza J.; Pilkington, Clarissa A.; Ravelli, Angelo; Van Royen-Kerkhof, Annet; Uziel, Yosef; Vastert, Sebastiaan J.; Wulffraat, Nico M.; Ozen, Seza; Brogan, Paul A.; Kamphuis, Sylvia; Beresford, Michael W.
(2017) Annals of the Rheumatic Diseases, volume 76, issue 10, pp. 1637 - 1641
(Article)
Abstract
Antiphospholipid syndrome (APS) is rare in children, and evidence-based guidelines are sparse. Consequently, management is mostly based on observational studies and physician's experience, and treatment regimens differ widely. The Single Hub and Access point for paediatric Rheumatology in Europe (SHARE) initiative was launched to develop diagnostic and management regimens for
... read more
children and young adults with rheumatic diseases. Here, we developed evidencebased recommendations for diagnosis and treatment of paediatric APS. Evidence-based recommendations were developed using the European League Against Rheumatism standard operating procedure. Following a detailed systematic review of the literature, a committee of paediatric rheumatologists and representation of paediatric haematology with expertise in paediatric APS developed recommendations. The literature review yielded 1473 articles, of which 15 were valid and relevant. In total, four recommendations for diagnosis and eight for treatment of paediatric APS (including paediatric Catastrophic Antiphospholipid Syndrome) were accepted. Additionally, two recommendations for children born to mothers with APS were accepted. It was agreed that new classification criteria for paediatric APS are necessary, and APS in association with childhoodonset systemic lupus erythematosus should be identified by performing antiphospholipid antibody screening. Treatment recommendations included prevention of thrombotic events, and treatment recommendations for venous and/or arterial thrombotic events. Notably, due to the paucity of studies on paediatric APS, level of evidence and strength of the recommendations is relatively low. The SHARE initiative provides international, evidencebased recommendations for diagnosis and treatment for paediatric APS, facilitating improvement and uniformity of care.
show less
Download/Full Text
The full text of this publication is not available.
Keywords: Rheumatology, Immunology and Allergy, Immunology, General Biochemistry,Genetics and Molecular Biology
ISSN: 0003-4967
Publisher: BMJ Publishing Group
Note: Funding Information: 1Wilhelmina Children’s Hospital, University Medical Centre, Utrecht, The Netherlands 2Sophia Children’s Hospital, Erasmus Medical Centre, Rotterdam, The Netherlands 3University Children’s Hospital, University Medical Centre, Ljubljana, Slovenia 4Necker Hospital, Assistance Publique-Hôpitaux de Paris, France 5General University Hospital, 1st Faculty of Medicine, Charles University, Prague, Czech Republic 6The Hospital for Sick Children, University of Toronto, Canada 7The Israel National Hemophilia Centre, Sackler Medical School, Sheba Medical Centre, Tel-Hashomer, Tel Aviv, Israel 8Bicêtre University Hospital, Paris, France 9Hospital for Children and Adolescents, University of Helsinki, Finland 10Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK 11Alder Hey Children’s Hospital NHS Foundation Trust, Liverpool, UK 12University of Liverpool, Liverpool, UK 13Università degli Studi di Genova and Istituto Giannina Gaslini, Genova, Italy 14Meir Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel 15Department of Pediatrics, Hacettepe University Medical Faculty, Ankara, Turkey contributors SK and MWB are senior authors. NMW and SJV designed the SHARE initiative. NG and NdG performed the systematic literature review, supervised by MB and SK. Validity assessment of selected papers was done by MWB, SK, TA, AR, IKP, BBM, CAP. Recommendations were formulated by NG, MWB and SK. The expert committee consisted of TA, BBM, PB, PD, IKP, PL, LM, SO, CAP, AR, AvR, YU, NMW, SK, MWB, SM, GK; they completed the online surveys and/ or participated in the subsequent consensus meetings. NG, NdG, SK and MWB prepared the consensus meetings, and NG and NdG chaired the meetings and took minutes. AR and BF facilitated the consensus procedure using nominal group technique. NG, SK and MWB wrote the manuscript, with contribution and approval of all co-authors. Publisher Copyright: © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. Copyright: Copyright 2017 Elsevier B.V., All rights reserved.
(Peer reviewed)