{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T22:10:15Z","timestamp":1782252615780,"version":"3.54.5"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,8,30]],"date-time":"2021-08-30T00:00:00Z","timestamp":1630281600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,8,30]],"date-time":"2021-08-30T00:00:00Z","timestamp":1630281600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Rheumatol"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Consensus treatment plans have been developed for induction therapy of newly diagnosed proliferative lupus nephritis (LN) in childhood-onset systemic lupus erythematosus. However, patients who do not respond to initial therapy, or who develop renal flare after remission, warrant escalation of treatment. Our objective was to assess current practices of pediatric nephrologists and rheumatologists in North America in treatment of refractory proliferative LN and flare.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Members of Childhood Arthritis and Rheumatology Research Alliance (CARRA) and the American Society for Pediatric Nephrology (ASPN) were surveyed in November 2015 to assess therapy choices (other than modifying steroid dosing) and level of agreement between rheumatologists and nephrologists for proliferative LN patients. Two cases were presented: (1) refractory disease after induction treatment with corticosteroid and cyclophosphamide (CYC) and (2) nephritis flare after initial response to treatment. Survey respondents chose treatments for three follow up scenarios for each case that varied by severity of presentation. Treatment options included CYC, mycophenolate mofetil (MMF), rituximab (RTX), and others, alone or in combination.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Seventy-six respondents from ASPN and foty-one respondents from CARRA represented approximately 15\u2009% of the eligible members from each organization. Treatment choices between nephrologists and rheumatologists were highly variable and received greater than 50\u2009% agreement for an individual treatment choice in only the following 2 of 6 follow up scenarios: 59\u2009% of nephrologists, but only 38\u2009% of rheumatologists, chose increasing dose of MMF in the case of LN refractory to induction therapy with proteinuria, hematuria, and improved serum creatinine. In a follow up scenario showing severe renal flare after achieving remission with induction therapy, 58\u2009% of rheumatologists chose CYC and RTX combination therapy, whereas the top choice for nephrologists (43\u2009%) was CYC alone. Rheumatologists in comparison to nephrologists chose more therapy options that contained RTX in all follow up scenarios except one (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Therapy choices for pediatric rheumatologists and nephrologists in the treatment of refractory LN or LN flare were highly variable with rheumatologists more often choosing rituximab. Further investigation is necessary to delineate the reasons behind this finding. This study highlights the importance of collaborative efforts in developing consensus treatment plans for pediatric LN.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12969-021-00627-w","type":"journal-article","created":{"date-parts":[[2021,8,30]],"date-time":"2021-08-30T11:02:53Z","timestamp":1630321373000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Differences in rituximab use between pediatric rheumatologists and nephrologists for the treatment of refractory lupus nephritis and renal flare in childhood-onset SLE"],"prefix":"10.1186","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3685-3764","authenticated-orcid":false,"given":"Mileka","family":"Gilbert","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice","family":"Goilav","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joyce J.","family":"Hsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul J.","family":"Nietert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esra","family":"Meidan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annabelle","family":"Chua","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacy P.","family":"Ardoin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott E.","family":"Wenderfer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"von Scheven","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasha M.","family":"Ruth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the Pediatric Nephrology and Rheumatology Collaborative Group, the Childhood Arthritis and Rheumatology Research Alliance, and the American Society for Pediatric Nephrology","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,8,30]]},"reference":[{"issue":"5","key":"627_CR1","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1097\/01.md.0000091181.93122.55","volume":"82","author":"R Cervera","year":"2003","unstructured":"Cervera R, Khamashta MA, Font J, Sebastiani GD, Gil A, Lavilla P, et al. Morbidity and mortality in systemic lupus erythematosus during a 10-year period: a comparison of early and late manifestations in a cohort of 1,000 patients. Med (Baltim). 2003;82(5):299\u2013308.","journal-title":"Med (Baltim)"},{"key":"627_CR2","doi-asserted-by":"crossref","unstructured":"Oni L, Wright RD, Marks S, Beresford MW, Tullus K. Kidney outcomes for children with lupus nephritis. Pediatr Nephrol. 2021;36:1377\u201385.","DOI":"10.1007\/s00467-020-04686-1"},{"issue":"13","key":"627_CR3","doi-asserted-by":"publisher","first-page":"1345","DOI":"10.1177\/0961203311416694","volume":"20","author":"B Livingston","year":"2011","unstructured":"Livingston B, Bonner A, Pope J. Differences in clinical manifestations between childhood-onset lupus and adult-onset lupus: a meta-analysis. Lupus. 2011;20(13):1345\u201355.","journal-title":"Lupus"},{"issue":"1","key":"627_CR4","doi-asserted-by":"publisher","first-page":"29","DOI":"10.2174\/1573397112666160404124308","volume":"13","author":"N Thakur","year":"2017","unstructured":"Thakur N, Rai N, Batra P. Pediatric Lupus Nephritis-Review of Literature. Curr Rheumatol Rev. 2017;13(1):29\u201336.","journal-title":"Curr Rheumatol Rev"},{"issue":"5","key":"627_CR5","doi-asserted-by":"publisher","first-page":"488","DOI":"10.1097\/BOR.0000000000000317","volume":"28","author":"J Couture","year":"2016","unstructured":"Couture J, Silverman ED. Update on the pathogenesis and treatment of childhood-onset systemic lupus erythematosus. Curr Opin Rheumatol. 2016;28(5):488\u201396.","journal-title":"Curr Opin Rheumatol"},{"issue":"10","key":"627_CR6","doi-asserted-by":"publisher","first-page":"614","DOI":"10.1056\/NEJM198603063141004","volume":"314","author":"HA Austin 3rd","year":"1986","unstructured":"Austin HA 3rd, Klippel JH, Balow JE, le Riche NG, Steinberg AD, Plotz PH, et al. Therapy of lupus nephritis. Controlled trial of prednisone and cytotoxic drugs. N Engl J Med. 1986;314(10):614\u20139.","journal-title":"N Engl J Med"},{"issue":"8822","key":"627_CR7","doi-asserted-by":"publisher","first-page":"741","DOI":"10.1016\/0140-6736(92)92292-N","volume":"340","author":"DT Boumpas","year":"1992","unstructured":"Boumpas DT, Austin HA 3rd, Vaughn EM, Klippel JH, Steinberg AD, Yarboro CH, et al. Controlled trial of pulse methylprednisolone versus two regimens of pulse cyclophosphamide in severe lupus nephritis. Lancet. 1992;340(8822):741\u20135.","journal-title":"Lancet"},{"issue":"7","key":"627_CR8","doi-asserted-by":"publisher","first-page":"549","DOI":"10.7326\/0003-4819-125-7-199610010-00003","volume":"125","author":"MF Gourley","year":"1996","unstructured":"Gourley MF, Austin HA 3rd, Scott D, Yarboro CH, Vaughan EM, Muir J, et al. Methylprednisolone and cyclophosphamide, alone or in combination, in patients with lupus nephritis. A randomized, controlled trial. Ann Intern Med. 1996;125(7):549\u201357.","journal-title":"Ann Intern Med"},{"issue":"4","key":"627_CR9","doi-asserted-by":"publisher","first-page":"248","DOI":"10.7326\/0003-4819-135-4-200108210-00009","volume":"135","author":"GG Illei","year":"2001","unstructured":"Illei GG, Austin HA, Crane M, Collins L, Gourley MF, Yarboro CH, et al. Combination therapy with pulse cyclophosphamide plus pulse methylprednisolone improves long-term renal outcome without adding toxicity in patients with lupus nephritis. Ann Intern Med. 2001;135(4):248\u201357.","journal-title":"Ann Intern Med"},{"issue":"5","key":"627_CR10","doi-asserted-by":"publisher","first-page":"1103","DOI":"10.1681\/ASN.2008101028","volume":"20","author":"GB Appel","year":"2009","unstructured":"Appel GB, Contreras G, Dooley MA, Ginzler EM, Isenberg D, Jayne D, et al. Mycophenolate mofetil versus cyclophosphamide for induction treatment of lupus nephritis. J Am Soc Nephrol. 2009;20(5):1103\u201312.","journal-title":"J Am Soc Nephrol"},{"issue":"3","key":"627_CR11","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1002\/acr.21558","volume":"64","author":"R Mina","year":"2012","unstructured":"Mina R, von Scheven E, Ardoin SP, Eberhard BA, Punaro M, Ilowite N, et al. Consensus treatment plans for induction therapy of newly diagnosed proliferative lupus nephritis in juvenile systemic lupus erythematosus. Arthritis Care Res (Hoboken). 2012;64(3):375\u201383.","journal-title":"Arthritis Care Res (Hoboken)"},{"issue":"5","key":"627_CR12","doi-asserted-by":"publisher","first-page":"904","DOI":"10.1016\/S0272-6386(00)70262-9","volume":"35","author":"SM Korbet","year":"2000","unstructured":"Korbet SM, Lewis EJ, Schwartz MM, Reichlin M, Evans J, Rohde RD. Factors predictive of outcome in severe lupus nephritis. Lupus Nephritis Collaborative Study Group. Am J Kidney Dis. 2000;35(5):904\u201314.","journal-title":"Am J Kidney Dis"},{"issue":"1","key":"627_CR13","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1046\/j.1523-1755.2000.00832.x","volume":"57","author":"JP Ioannidis","year":"2000","unstructured":"Ioannidis JP, Boki KA, Katsorida ME, Drosos AA, Skopouli FN, Boletis JN, et al. Remission, relapse, and re-remission of proliferative lupus nephritis treated with cyclophosphamide. Kidney Int. 2000;57(1):258\u201364.","journal-title":"Kidney Int"},{"issue":"8","key":"627_CR14","doi-asserted-by":"publisher","first-page":"2559","DOI":"10.1002\/art.20364","volume":"50","author":"CC Mok","year":"2004","unstructured":"Mok CC, Ying KY, Tang S, Leung CY, Lee KW, Ng WL, et al. Predictors and outcome of renal flares after successful cyclophosphamide treatment for diffuse proliferative lupus glomerulonephritis. Arthritis Rheum. 2004;50(8):2559\u201368.","journal-title":"Arthritis Rheum"},{"issue":"21","key":"627_CR15","doi-asserted-by":"publisher","first-page":"2219","DOI":"10.1056\/NEJMoa043731","volume":"353","author":"EM Ginzler","year":"2005","unstructured":"Ginzler EM, Dooley MA, Aranow C, Kim MY, Buyon J, Merrill JT, et al. Mycophenolate mofetil or intravenous cyclophosphamide for lupus nephritis. N Engl J Med. 2005;353(21):2219\u201328.","journal-title":"N Engl J Med"},{"issue":"16","key":"627_CR16","doi-asserted-by":"publisher","first-page":"1156","DOI":"10.1056\/NEJM200010193431604","volume":"343","author":"TM Chan","year":"2000","unstructured":"Chan TM, Li FK, Tang CS, Wong RW, Fang GX, Ji YL, et al. Efficacy of mycophenolate mofetil in patients with diffuse proliferative lupus nephritis. Hong Kong-Guangzhou Nephrology Study Group. N Engl J Med. 2000;343(16):1156\u201362.","journal-title":"N Engl J Med"},{"issue":"5","key":"627_CR17","first-page":"705","volume":"115","author":"W Hu","year":"2002","unstructured":"Hu W, Liu Z, Chen H, Tang Z, Wang Q, Shen K, et al. Mycophenolate mofetil vs cyclophosphamide therapy for patients with diffuse proliferative lupus nephritis. Chin Med J (Engl). 2002;115(5):705\u20139.","journal-title":"Chin Med J (Engl)"},{"issue":"11","key":"627_CR18","doi-asserted-by":"publisher","first-page":"1969","DOI":"10.1007\/s00467-015-3138-y","volume":"30","author":"P Rianthavorn","year":"2015","unstructured":"Rianthavorn P, Buddhasri A. Long-term renal outcomes of childhood-onset global and segmental diffuse proliferative lupus nephritis. Pediatr Nephrol. 2015;30(11):1969\u201376.","journal-title":"Pediatr Nephrol"},{"issue":"7","key":"627_CR19","doi-asserted-by":"publisher","first-page":"981","DOI":"10.1007\/s00467-007-0447-9","volume":"22","author":"D Askenazi","year":"2007","unstructured":"Askenazi D, Myones B, Kamdar A, Warren R, Perez M, De Guzman M, et al. Outcomes of children with proliferative lupus nephritis: the role of protocol renal biopsy. Pediatr Nephrol. 2007;22(7):981\u20136.","journal-title":"Pediatr Nephrol"},{"issue":"2","key":"627_CR20","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1007\/s00467-006-0286-0","volume":"22","author":"BS Lee","year":"2007","unstructured":"Lee BS, Cho HY, Kim EJ, Kang HG, Ha IS, Cheong HI, et al. Clinical outcomes of childhood lupus nephritis: a single center\u2019s experience. Pediatr Nephrol. 2007;22(2):222\u201331.","journal-title":"Pediatr Nephrol"},{"issue":"9","key":"627_CR21","doi-asserted-by":"publisher","first-page":"898","DOI":"10.1177\/0961203314531841","volume":"23","author":"A Boneparth","year":"2014","unstructured":"Boneparth A, Ilowite NT, Investigators CR. Comparison of renal response parameters for juvenile membranous plus proliferative lupus nephritis versus isolated proliferative lupus nephritis: a cross-sectional analysis of the CARRA Registry. Lupus. 2014;23(9):898\u2013904.","journal-title":"Lupus"},{"issue":"5","key":"627_CR22","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1177\/0961203319836712","volume":"28","author":"E Smith","year":"2019","unstructured":"Smith E, Al-Abadi E, Armon K, Bailey K, Ciurtin C, Davidson J, et al. Outcomes following mycophenolate mofetil versus cyclophosphamide induction treatment for proliferative juvenile-onset lupus nephritis. Lupus. 2019;28(5):613\u201320.","journal-title":"Lupus"},{"issue":"6","key":"627_CR23","doi-asserted-by":"publisher","first-page":"1541","DOI":"10.1093\/ndt\/gfk073","volume":"21","author":"G Moroni","year":"2006","unstructured":"Moroni G, Gallelli B, Quaglini S, Banfi G, Rivolta E, Messa P, et al. Withdrawal of therapy in patients with proliferative lupus nephritis: long-term follow-up. Nephrol Dial Transplant. 2006;21(6):1541\u20138.","journal-title":"Nephrol Dial Transplant"},{"issue":"4","key":"627_CR24","doi-asserted-by":"publisher","first-page":"995","DOI":"10.1002\/art.10142","volume":"46","author":"GG Illei","year":"2002","unstructured":"Illei GG, Takada K, Parkin D, Austin HA, Crane M, Yarboro CH, et al. Renal flares are common in patients with severe proliferative lupus nephritis treated with pulse immunosuppressive therapy: long-term followup of a cohort of 145 patients participating in randomized controlled studies. Arthritis Rheum. 2002;46(4):995\u20131002.","journal-title":"Arthritis Rheum"},{"issue":"4","key":"627_CR25","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1016\/j.semarthrit.2013.07.005","volume":"43","author":"JY Wu","year":"2014","unstructured":"Wu JY, Yeh KW, Huang JL. Early predictors of outcomes in pediatric lupus nephritis: focus on proliferative lesions. Semin Arthritis Rheum. 2014;43(4):513\u201320.","journal-title":"Semin Arthritis Rheum"},{"issue":"4","key":"627_CR26","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1177\/0961203315615220","volume":"25","author":"E Aragon","year":"2016","unstructured":"Aragon E, Resontoc LP, Chan YH, Lau YW, Tan PH, Loh HL, et al. Long-term outcomes with multi-targeted immunosuppressive protocol in children with severe proliferative lupus nephritis. Lupus. 2016;25(4):399\u2013406.","journal-title":"Lupus"},{"issue":"5","key":"627_CR27","doi-asserted-by":"publisher","first-page":"510","DOI":"10.1016\/j.autrev.2019.03.004","volume":"18","author":"A Kronbichler","year":"2019","unstructured":"Kronbichler A, Brezina B, Gauckler P, Quintana LF, Jayne DRW. Refractory lupus nephritis: When, why and how to treat. Autoimmun Rev. 2019;18(5):510\u20138.","journal-title":"Autoimmun Rev"},{"issue":"11","key":"627_CR28","doi-asserted-by":"publisher","first-page":"3096","DOI":"10.1002\/art.38790","volume":"66","author":"AT Group","year":"2014","unstructured":"Group AT. Treatment of lupus nephritis with abatacept: the Abatacept and Cyclophosphamide Combination Efficacy and Safety Study. Arthritis Rheumatol. 2014;66(11):3096\u2013104.","journal-title":"Arthritis Rheumatol"},{"key":"627_CR29","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1016\/j.jpeds.2017.05.002","volume":"187","author":"I Mahmoud","year":"2017","unstructured":"Mahmoud I, Jellouli M, Boukhris I, Charfi R, Ben Tekaya A, Saidane O, et al. Efficacy and safety of rituximab in the management of pediatric systemic lupus erythematosus: a systematic review. J Pediatr. 2017;187:213\u20139.","journal-title":"J Pediatr"},{"issue":"4","key":"627_CR30","doi-asserted-by":"publisher","first-page":"1215","DOI":"10.1002\/art.34359","volume":"64","author":"BH Rovin","year":"2012","unstructured":"Rovin BH, Furie R, Latinis K, Looney RJ, Fervenza FC, Sanchez-Guerrero J, et al. Efficacy and safety of rituximab in patients with active proliferative lupus nephritis: the Lupus Nephritis Assessment with Rituximab study. Arthritis Rheum. 2012;64(4):1215\u201326.","journal-title":"Arthritis Rheum"},{"issue":"1","key":"627_CR31","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1007\/s00467-017-3767-4","volume":"33","author":"J Hogan","year":"2018","unstructured":"Hogan J, Godron A, Baudouin V, Kwon T, Harambat J, Deschenes G, et al. Combination therapy of rituximab and mycophenolate mofetil in childhood lupus nephritis. Pediatr Nephrol. 2018;33(1):111\u20136.","journal-title":"Pediatr Nephrol"},{"issue":"6","key":"627_CR32","doi-asserted-by":"publisher","first-page":"1013","DOI":"10.1007\/s00467-017-3583-x","volume":"32","author":"B Basu","year":"2017","unstructured":"Basu B, Roy B, Babu BG. Efficacy and safety of rituximab in comparison with common induction therapies in pediatric active lupus nephritis. Pediatr Nephrol. 2017;32(6):1013\u201321.","journal-title":"Pediatr Nephrol"},{"issue":"10","key":"627_CR33","doi-asserted-by":"publisher","first-page":"1502","DOI":"10.2215\/CJN.01070118","volume":"13","author":"LM Gomez Mendez","year":"2018","unstructured":"Gomez Mendez LM, Cascino MD, Garg J, Katsumoto TR, Brakeman P, Dall\u2019Era M, et al. Peripheral Blood B Cell Depletion after Rituximab and Complete Response in Lupus Nephritis. Clin J Am Soc Nephrol. 2018;13(10):1502\u20139.","journal-title":"Clin J Am Soc Nephrol"},{"issue":"7","key":"627_CR34","doi-asserted-by":"publisher","first-page":"1479","DOI":"10.1016\/j.clinthera.2017.05.359","volume":"39","author":"TA Shamliyan","year":"2017","unstructured":"Shamliyan TA, Dospinescu P. Additional Improvements in Clinical Response From Adjuvant Biologic Response Modifiers in Adults With Moderate to Severe Systemic Lupus Erythematosus Despite Immunosuppressive Agents: A Systematic Review and Meta-analysis. Clin Ther. 2017;39(7):1479\u2013506. e45.","journal-title":"Clin Ther"},{"issue":"2","key":"627_CR35","doi-asserted-by":"publisher","first-page":"118","DOI":"10.5152\/eurjrheum.2018.17096","volume":"5","author":"F Alshaiki","year":"2018","unstructured":"Alshaiki F, Obaid E, Almuallim A, Taha R, El-Haddad H, Almoallim H. Outcomes of rituximab therapy in refractory lupus: A meta-analysis. Eur J Rheumatol. 2018;5(2):118\u201326.","journal-title":"Eur J Rheumatol"},{"issue":"11","key":"627_CR36","doi-asserted-by":"publisher","first-page":"1771","DOI":"10.1136\/annrheumdis-2012-201940","volume":"71","author":"GK Bertsias","year":"2012","unstructured":"Bertsias GK, Tektonidou M, Amoura Z, Aringer M, Bajema I, Berden JH, et al. Joint European League Against Rheumatism and European Renal Association-European Dialysis and Transplant Association (EULAR\/ERA-EDTA) recommendations for the management of adult and paediatric lupus nephritis. Ann Rheum Dis. 2012;71(11):1771\u201382.","journal-title":"Ann Rheum Dis"},{"issue":"6","key":"627_CR37","doi-asserted-by":"publisher","first-page":"797","DOI":"10.1002\/acr.21664","volume":"64","author":"BH Hahn","year":"2012","unstructured":"Hahn BH, McMahon MA, Wilkinson A, Wallace WD, Daikh DI, Fitzgerald JD, et al. American College of Rheumatology guidelines for screening, treatment, and management of lupus nephritis. Arthritis Care Res (Hoboken). 2012;64(6):797\u2013808.","journal-title":"Arthritis Care Res (Hoboken)"},{"issue":"8","key":"627_CR38","doi-asserted-by":"publisher","first-page":"840","DOI":"10.1038\/ki.2012.280","volume":"82","author":"J Radhakrishnan","year":"2012","unstructured":"Radhakrishnan J, Cattran DC. The KDIGO practice guideline on glomerulonephritis: reading between the (guide)lines\u2013application to the individual patient. Kidney Int. 2012;82(8):840\u201356.","journal-title":"Kidney Int"},{"issue":"2","key":"627_CR39","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1016\/j.kint.2018.11.008","volume":"95","author":"BH Rovin","year":"2019","unstructured":"Rovin BH, Caster DJ, Cattran DC, Gibson KL, Hogan JJ, Moeller MJ, et al. Management and treatment of glomerular diseases (part 2): conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney Int. 2019;95(2):281\u201395.","journal-title":"Kidney Int"},{"issue":"12","key":"627_CR40","doi-asserted-by":"publisher","first-page":"1117","DOI":"10.1056\/NEJMoa2001180","volume":"383","author":"R Furie","year":"2020","unstructured":"Furie R, Rovin BH, Houssiau F, Malvar A, Teng YKO, Contreras G, et al. Two-Year, Randomized, Controlled Trial of Belimumab in Lupus Nephritis. N Engl J Med. 2020;383(12):1117\u201328.","journal-title":"N Engl J Med"},{"issue":"1","key":"627_CR41","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1186\/s12882-018-0847-z","volume":"19","author":"DPE Margiotta","year":"2018","unstructured":"Margiotta DPE, Basta F, Batani V, Afeltra A. Belimumab and low-doses of mycophenolate mofetil as induction therapy of class IV lupus nephritis: case series and literature review. BMC Nephrol. 2018;19(1):54.","journal-title":"BMC Nephrol"},{"issue":"2","key":"627_CR42","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1007\/s12016-018-8675-2","volume":"54","author":"F Trentin","year":"2018","unstructured":"Trentin F, Gatto M, Zen M, Larosa M, Maddalena L, Nalotto L, et al. Effectiveness, tolerability, and safety of belimumab in patients with refractory SLE: a review of observational clinical-practice-based studies. Clin Rev Allergy Immunol. 2018;54(2):331\u201343.","journal-title":"Clin Rev Allergy Immunol"}],"container-title":["Pediatric Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12969-021-00627-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12969-021-00627-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12969-021-00627-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,30]],"date-time":"2021-08-30T12:11:29Z","timestamp":1630325489000},"score":1,"resource":{"primary":{"URL":"https:\/\/ped-rheum.biomedcentral.com\/articles\/10.1186\/s12969-021-00627-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,30]]},"references-count":42,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["627"],"URL":"https:\/\/doi.org\/10.1186\/s12969-021-00627-w","relation":{},"ISSN":["1546-0096"],"issn-type":[{"value":"1546-0096","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,30]]},"assertion":[{"value":"31 March 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 July 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 August 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Internal Review Board exemption for study was obtained at Nationwide Children\u2019s Hospital, IRB # IRB15-00843.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors have no financial competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"137"}}