Active implementation of low disease activity state as a treatment endpoint in childhood-onset systemic lupus erythematosus in routine practice is both feasible and associated with better outcomes.

T2T strategy implementation was achievable and associated with improved cSLE control. Spending at least 3/12 months in cLLDAS led to less damage accumulation. Key Points • This is the first large prospective study in AYA with cSLE to evaluate the impact of active T2T implementation in routine practice. • T2T strategies were feasible to implement in 122/135 (91.2%) AYA with cSLE in routine practice. • The T2T approach was associated with improved disease control and decreased damage accrual at 12 months.