TEACH: A cognitive behavioral therapy for youth with cSLE

Results from a pilot, two-arm, randomized controlled trial (NCT04335643) evaluating Treatment and Education Approach for Childhood-Onset Lupus (TEACH), a remotely delivered, six-session cognitive behavioral therapy (CBT) intervention, in adolescents and young adults (12–22 years) with childhood-onset systemic lupus erythematosus (cSLE) were published in Arthritis Care & Research by Cunningham et al. The primary outcome was feasibility, assessed using recruitment, retention rates, and qualitative interviews.

Key data: Among 200 youth approached, 97 enrolled (48.5% recruitment), of whom 64 were eligible and were randomized 1:1 to TEACH + medical treatment as usual (TAU) or TAU alone (92.2% retention). At 8 weeks post assessment, TEACH + TAU was associated with a 14% decrease in depressive symptom T-scores (estimated marginal mean, 7.88; 95% confidence interval [CI], 3.20–12.60) and a 7% decrease in fatigue T-scores (estimated marginal mean, 3.91; 95% CI, 0.44–7.39) relative to TAU alone. There was no significant effect on pain intensity.

Key learning: Remotely delivered TEACH is feasible and acceptable for youth with cSLE and is associated with meaningful reductions in depressive and fatigue symptoms relative to TAU alone, supporting integration of nonpharmacologic behavioral interventions into multidisciplinary cSLE care.