Creating evidence-based standards for steroid use in lupus treatment
The Collaborative Lupus Initiative for New Glucocorticoid Strategies (CLING) is working to create more-effective and safer glucocorticoid treatment plans for those diagnosed with systemic lupus erythematosus (SLE).
Collaborative Lupus Initiative for New Glucocorticoid Strategies (CLING)
The Collaborative Lupus Initiative for New Glucocorticoid Strategies (CLING) is an international initiative that seeks to optimize glucocorticoid dosing to better manage lupus nephritis. This condition affects nearly half of those diagnosed with systemic lupus erythematosus (SLE).
For over 70 years, glucocorticoids have been a cornerstone in SLE treatment. They offer significant benefits by reducing swelling and preventing more-severe complications. But their use comes with a higher infection risk, which is a leading cause of death in patients with SLE. This underscores the urgent need for tailored glucocorticoid therapy. CLING seeks to close the critical evidence gap in glucocorticoid dosing and enhance the safety and effectiveness of lupus nephritis treatment.
CLING focuses on creating evidence-based standards for steroid use in lupus treatment. The lab's research is poised to set new standards in SLE management that will lead to more-effective and safer glucocorticoid treatment plans.
Research goals
CLING is addressing the significant gap in knowledge regarding the optimal glucocorticoid dosage to manage lupus nephritis. Despite the crucial role of glucocorticoids, there is a lack of large, randomized studies to pinpoint the most-effective dosing strategies.
International collaborations include:
- Individual patient data meta-analysis. This collaboration is conducting an individual patient data meta-analysis of standard care in randomized clinical trials. These trials are studying how the relationship between glucocorticoid treatment duration and cumulative dose affects outcomes such as relapses, remission, serious infections and death.
- Consensus development. This collaboration is using consensus methods to devise a standardized glucocorticoid treatment plan for lupus nephritis. This treatment plan aims to guide clinical practice and clinical trials and set a benchmark for studying other glucocorticoid protocols.
The Rheumatology Research Foundation and the Lupus Research Alliance provide funding for these projects.
Leadership
Steering committee members
- Maria Dall'Era, M.D., University of California, San Francisco.
- Frédéric Houssiau, M.D., Ph.D., Cliniques Universitaires Saint-Luc, Brussels, Belgium.
- Brad Rovin, M.D., The Ohio State University, Wexner Medical Center.
Team members:
- Sirirat Anutrakulchai, M.D., Khon Kaen University, Khon Kaen, Thailand.
- Yingyos Avihingsanon, M.D., Khon Kaen University, Khon Kaen, Thailand.
- Tak Mao Chan, M.D., School of Clinical Medicine at The University of Hong Kong, China.
- Maria Carolina Cuellar Gutierrez, Hospital del Salvador, Santiago, Chile.
- Gabriel Figueroa-Parra, M.D., Mayo Clinic.
- Jaime Flores Gouyonnet, M.D., Mayo Clinic.
- Lai Hooi, M.D., Sultanah Aminah Hospital, Johor Bahru, Malaysia.
- Cassondra A. Hulshizer, Mayo Clinic.
- David Jayne, M.D., Addenbrooke’s Hospital, Cambridge, UK.
- Satish Mendonca, M.D., Bharati Vidyapeeth Deemed University and Hospital Pune, Chandigarh, India.
- Manish Rathi, M.D., Post Graduate Institute of Medical Education & Research, Chandigarh, India.
- Brenna E. Sharp, Mayo Clinic.
- Farah Tamirou, M.D., Ph.D., Cliniques Universitaires Saint-Luc, Brussels, Belgium.