Efficacy and safety of nonbiologic immunosuppressants in the treatment of nonrenal systemic lupus erythematosus: a systematic review
Open accessAbstract
OBJECTIVE: To analyze the efficacy and safety of nonbiologic immunosuppressants in the treatment of nonrenal systemic lupus erythematosus (SLE). METHODS: We conducted a sensitive literature search in Medline, Embase, and the Cochrane Central Register of Controlled Trials up to October 2011. The selection criteria were studies including adult patients with SLE, a treatment intervention with nonbiologic immunosuppressants, a placebo or active comparator group, and outcome measures assessing efficacy and/or safety. Meta-analyses, systematic reviews, clinical trials, and cohort studies were included. The quality of each study was evaluated using Jadad’s scale and the Oxford Levels of Evidence. RESULTS: In total, 158 of the 2,827 initially found articles were selected for detailed review; 65 studies fulfilled the predetermined criteria. Overall, the studies were low quality, with only 11 randomized controlled trials (RCTs). Cyclophosphamide demonstrated efficacy for neuropsychiatric SLE, preventing relapses with an additional steroid sparing effect, although its use was associated with cumulative damage, development of cervical intraepithelial neoplasia,and ovarian failure. Other immunosuppressants (azathioprine, methotrexate, leflunomide, mycophenolate mofetil,and cyclosporin A) demonstrated efficacy in reducing nonrenal activity and flares with a steroid-sparing effect, although only on occasion in non–placebo-controlled RCTs of small numbers of patients. CONCLUSION: Several immunosuppressants demonstrated their safety and efficacy in nonrenal SLE. A specific drug for each particular manifestation cannot be recommended, although cyclophosphamide may be used in more severe cases, and methotrexate may be the first option in most cases of moderately active SLE. High-quality RCTs of larger numbers of patients are needed.
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Consequent initiation of immunosuppressive drugs facilitates a more rapid glucocorticoid tapering and may prevent disease flares.
“Consequent initiation of IS drugs facilitates a more rapid GC tapering and may prevent disease flares.”
From 2019 update of the EULAR recommendations for the management of systemic lupus erythematosus (2019) · cites this paper as [49]
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RetractedAssessing the quality of reports of randomized clinical trials: Is blinding necessary?
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Cobo‐Ibáñez, T., Loza, E., Pego‐Reigosa, J. M., Olivé, A., Rúa‐Figueroa, Í., Fernández‐Nebro, A., Cáliz, R., Longo, F. J. L., & Muñoz‐Fernández, S. (2014) · Seminars in Arthritis and Rheumatism · doi:10.1016/j.semarthrit.2014.04.002 · Cited by 117 · see citing works
2020 Chinese guidelines for the diagnosis and treatment of systemic lupus erythematosus
Li, M., Zhao, Y., Zhang, Z., Huang, C., Liu, Y., Gu, J., Zhang, X., Xu, H., Li, X., Wu, L., et al. (2020) · Rheumatology and Immunology Research · doi:10.2478/rir-2020-0009 · Cited by 74 · see citing works
“Methotrexate Patients with mild to moderate SLE without renal involvement([97]) It has good efficacy in improving skin, arthritis and overall condition in patients with SLE.”
BackgroundRúa‐Figueroa, Í., López-Longo, F. J., Alén, J. C., Galindo-Izquierdo, M., Loza, E., de Yébenes, M. J. G., & Pego‐Reigosa, J. M. (2013) · Reumatología Clínica · doi:10.1016/j.reuma.2013.04.013 · Cited by 72 · see citing works
Changing paradigms in the treatment of systemic lupus erythematosus
Fanouriakis, A., & Bertsias, G. K. (2019) · Lupus Science & Medicine · doi:10.1136/lupus-2018-000310 · Cited by 59 · see citing works
“37 38 Observational studies regarding the efficacy of the various IS drugs in extrarenal disease have been published, 39 40 but these results are not always easy to generalise.”
Tselios, K., Gladman, D. D., Su, J., & Urowitz, M. B. (2016) · The Journal of Rheumatology · doi:10.3899/jrheum.150779 · Cited by 56 · see citing works
Alamri, R. D., Elmeligy, M. A., Albalawi, G. A., Alquayr, S. M. A., Alsubhi, S. S., & El-Ghaiesh, S. H. (2021) · International Immunopharmacology · doi:10.1016/j.intimp.2021.107398 · Cited by 53 · see citing works
Research and therapeutics—traditional and emerging therapies in systemic lupus erythematosus
Davis, L. S., & Reimold, A. M. (2017) · Rheumatology · doi:10.1093/rheumatology/kew417 · Cited by 52 · see citing works
Central Nervous System Manifestations of Systemic Lupus Erythematosus
Jafri, K., Patterson, S. L., & Lanata, C. M. (2017) · Rheumatic Disease Clinics of North America · doi:10.1016/j.rdc.2017.06.003 · Cited by 47 · see citing works
Jin, H.-Z., Li, Y.-J., Wang, X., Li, Z., Ma, B., Niu, L., Wang, P., Pan, H., Li, S., Bao, W., et al. (2023) · Lupus Science & Medicine · doi:10.1136/lupus-2023-001074 · Cited by 46 · see citing works
Systemic lupus erythematosus diagnosis and management
Thong, B., & Olsen, N. J. (2016) · Rheumatology · doi:10.1093/rheumatology/kew401 · Cited by 120 · see citing works
Autoimmunity, neuroinflammation, pathogen load: A decisive crosstalk in neuropsychiatric SLE
Jeltsch‐David, H., & Muller, S. (2016) · Journal of Autoimmunity · doi:10.1016/j.jaut.2016.04.005 · Cited by 39 · see citing works
Jesús, D., Rodrigues, M., da Silva, J. A. P., & Inês, L. (2018) · Lupus · doi:10.1177/0961203318758508 · Cited by 38 · see citing works
Systemic lupus erythematosus: An update for ophthalmologists
Papagiannuli, E., Rhodes, B., Wallace, G. R., Gordon, C., Murray, P. I., & Denniston, A. K. (2015) · Survey of Ophthalmology · doi:10.1016/j.survophthal.2015.06.003 · Cited by 38 · see citing works
Current Treatment Approach, Emerging Therapies and New Horizons in Systemic Lupus Erythematosus
Athanassiou, P., & Athanassiou, L. (2023) · Life · doi:10.3390/life13071496 · Cited by 42 · see citing works
Rúa‐Figueroa, Í., López-Longo, F. J., Alén, J. C., Galindo-Izquierdo, M., Loza, E., de Yébenes, M. J. G., & Pego‐Reigosa, J. M. (2013) · Reumatología Clínica (English Edition) · doi:10.1016/j.reumae.2013.11.006 · Cited by 32 · see citing works
Pego‐Reigosa, J. M., Rúa‐Figueroa, Í., López-Longo, F. J., Galindo-Izquierdo, M., Alén, J. C., Olivé, A., del Campo, V., García-Yébenes, M. J., Loza, E., Blanco, R., et al. (2014) · Lupus · doi:10.1177/0961203314563818 · Cited by 30 · see citing works
Unveiling Ocular Manifestations in Systemic Lupus Erythematosus
Musa, M., Chukwuyem, E., Ojo, O. M., Topah, E. K., Spadea, L., Salati, C., Gagliano, C., & Zeppieri, M. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13041047 · Cited by 25 · see citing works
Trujillo‐Martín, M. M., de Larrinoa, Í. R.-F. F., Ruiz‐Irastorza, G., Pego‐Reigosa, J. M., Sabio, J. M., & Serrano-Aguilar, P. G. (2016) · Medicina Clínica · doi:10.1016/j.medcli.2016.01.013 · Cited by 22 · see citing works
Myositis registries and biorepositories
Rider, L. G., Dankó, K., & Miller, F. W. (2014) · Current Opinion in Rheumatology · doi:10.1097/bor.0000000000000119 · Cited by 21 · see citing works
Neurologic Manifestations of Systemic Rheumatologic Diseases
Bradshaw, M. J., Bhattacharyya, S., Venna, N., & Cahill, J. F. X. (2019) · Current clinical neurology · doi:10.1007/978-3-030-24436-1_17 · Cited by 18 · see citing works
Characteristics of azathioprine use and cessation in a longitudinal lupus cohort
Croyle, L., Hoi, A. Y.-B., & Morand, E. F. (2015) · Lupus Science & Medicine · doi:10.1136/lupus-2015-000105 · Cited by 16 · see citing works
“not universally implemented in rheumatology practice, and there is a lack of consensus about indications for initiation and cessation of AZA therapy in SLE, with no widely accepted treatment guidelines for its use.(5) In addition, current weight-based dosing regimens for AZA fail to reflect inter-patient variability o…”
BackgroundPatterns of drug therapy in newly diagnosed Spanish patients with systemic lupus erythematosus.
Ruiz‐Irastorza, G., García, M., Espinosa, G., Cabezas‐Rodríguez, I., Mitjavila, F., González-León, R., SOPEÑA, B., Perales, I., Pinilla, B., Rodríguez‐Carballeira, M., et al. (2016) · PubMed · Cited by 14 · see citing works
Trujillo‐Martín, M. M., de Larrinoa, Í. R.-F. F., Ruiz‐Irastorza, G., Pego‐Reigosa, J. M., Sabio, J. M., & Serrano-Aguilar, P. G. (2016) · Medicina Clínica (English Edition) · doi:10.1016/j.medcle.2016.06.033 · Cited by 14 · see citing works
Bechman, K., Song, K., Abhishek, A., Adas, M. A., Ahmed, A., Bray, L., Davidson, A., Deepak, S., Dey, M., Vere, H. D., et al. (2025) · Rheumatology · doi:10.1093/rheumatology/keaf522 · Cited by 15 · see citing works
Sheu, H.-S., Chen, Y., Liao, Y., Wei, C., Chen, J., Lin, H., Hung, W., Huang, W., & Chen, Y. (2022) · Journal of Personalized Medicine · doi:10.3390/jpm12091399 · Cited by 13 · see citing works
Update on Biologic Therapies for Systemic Lupus Erythematosus
Borba, H. H. L., Funke, A., Wiens, A., Utiyama, S. R. R., Perlin, C. M., & Pontarolo, R. (2016) · Current Rheumatology Reports · doi:10.1007/s11926-016-0589-5 · Cited by 11 · see citing works
Altabás‐González, I., Rúa‐Figueroa, Í., Mouriño, C., Roberts, K. C., Jiménez, N., Martínez‐Barrio, J., Galindo-Izquierdo, M., Alén, J. C., del Campo-Pérez, V., Itzazelaia, E. U., et al. (2024) · Lupus Science & Medicine · doi:10.1136/lupus-2023-001064 · Cited by 11 · see citing works
“46 Thus, it is not surprising that those are the systems that accrue more damage early after diagnosis.”
BackgroundOliveira, M., Fernández, S. P., Cervera, R., & Espinosa, G. (2020) · Rheumatology · doi:10.1093/rheumatology/keaa142 · Cited by 9 · see citing works
2025 Chinese guidelines for the diagnosis and treatment of systemic lupus erythematosus
Zhao, J., Zhang, S., Wang, Q., Tian, X., Chen, Y., Li, M., & Zeng, X. (2025) · Rheumatology and Immunology Research · doi:10.1515/rir-2025-0017 · Cited by 8 · see citing works
Therapeutic Effects of Triptolide on Lupus-prone MRL/lpr Mice
Huang, X., Wen, C., & Wei, H. (2018) · International Journal of Pharmacology · doi:10.3923/ijp.2018.681.688 · Cited by 8 · see citing works
Can we treat systemic lupus erythematosus and other autoimmune diseases without oral steroids?
Merayo, E. E., Sciascia, S., Roccatello, D., & Cuadrado, M. J. (2018) · Expert Review of Clinical Immunology · doi:10.1080/1744666x.2018.1527219 · Cited by 8 · see citing works
“The two systematic reviews already commented [20,21] summarized”
BackgroundDiagnosis and treatment of articular manifestations of systemic lupus erythematosus
Frade‐Sosa, B., Sarmiento-Monroy, J. C., Salman-Monte, T. C., Corzo, P., & Gómez-Puerta, J. A. (2021) · Revista Colombiana de Reumatología · doi:10.1016/j.rcreu.2021.05.003 · Cited by 7 · see citing works
Tocut, M., Shoenfeld, Y., & Zandman‐Goddard, G. (2020) · Expert Opinion on Investigational Drugs · doi:10.1080/13543784.2020.1807004 · Cited by 7 · see citing works
Elevation of serum fibroblast growth factor 23 level in a pediatric patient with lupus nephritis
Shimazaki, S., Kazukawa, I., Yamammoto, H., Mori, K., Kihara, M., Naruke, Y., & Minagawa, M. (2021) · CEN Case Reports · doi:10.1007/s13730-021-00625-7 · Cited by 6 · see citing works
Treatment patterns in patients with systemic lupus erythematosus in New Zealand
Lao, C., Dantzig, P. V., Tugnet, N., Lawrenson, R. A., & White, D. (2024) · Lupus · doi:10.1177/09612033241274911 · Cited by 6 · see citing works
“8 One key aspect to facilitate this study is to improve the funded pharmacological options for management of SLE in New Zealand.”
BackgroundTreatment of Systemic Lupus Erythematosus
Kim, B. Y., & Kim, S.-S. (2020) · Korean Journal of Medicine · doi:10.3904/kjm.2020.95.3.162 · Cited by 6 · see citing works
“면역억제제는 글루코코르티코이드 용량의 빠른 감량을 가 능하게 하고, 루푸스 플레어를 예방한다[19].”
Попкова, Т. В., Panafidina, T. A., & Solovyev, S. K. (2019) · Rheumatology Science and Practice · doi:10.14412/1995-4484-2019-496-510 · Cited by 6 · see citing works
Musculoskeletal Manifestations of Systemic Lupus Erythematosus
Smiljanić, L. (2023) · Acta Clinica Croatica · doi:10.20471/acc.2023.62.04.18 · Cited by 3 · see citing works
The Musculoskeletal System and Bone Metabolism
Navarra, S., & Torralba, T. P. (2019) · Elsevier eBooks · doi:10.1016/b978-0-323-47927-1.00034-7 · Cited by 3 · see citing works
Saudi National Clinical Practice Guidelines for Management of Adult Systemic Lupus Erythematosus
Al-Jedai, A. H., Almudaiheem, H., Al-Homood, I. A., AlMaghlouth, I. A., Bahlas, S. M., Alolaiwi, A. M., Fatani, M. I. A., Eshmawi, M. T., Al-Omari, B. A., Alenzi, K. A. O., et al. (2024) · Current Rheumatology Reviews · doi:10.2174/0115733971275638240429063041 · Cited by 3 · see citing works
Methotrexate injection: An old drug with a newly developing landscape
Tan, N., Hsu, C., Mo, H., Yang, X., & Wei, J. C. (2023) · International Journal of Rheumatic Diseases · doi:10.1111/1756-185x.14879 · Cited by 3 · see citing works
Pulmonary Manifestations of Systemic Lupus Erythematosus
Goldberg, H. J., & Dellaripa, P. F. (2012) · Springer eBooks · doi:10.1007/978-1-4614-1189-5_9 · Cited by 3 · see citing works
Zhan, J., Chen, F., Cao, J., Jin, Y., Wang, Y., Ting, W., Zhang, J., & Changzheng, H. (2024) · Clinical Rheumatology · doi:10.1007/s10067-024-07067-3 · Cited by 2 · see citing works
“They have shown effectiveness in managing disease flares and refractory cases of SLE, potentially reducing the required dosage of glucocorticoids [16].”
The musculoskeletal system and bone metabolism
Sandhu, V. K., Torralba, K. D., & Cabling, M. G. (2024) · Elsevier eBooks · doi:10.1016/b978-0-323-93232-5.00041-1 · Cited by 2 · see citing works
Andrade-Ortega, L., Xibille-Friedmann, D. X., Galarza-Delgado, D. Á., Saavedra, M. Á., Álvarez-Nemegyei, J., Castañeda, M. C. A., Fragoso-Loyo, H. E., Gordillo-Huerta, M. V., Irazoque-Palazuelos, F. C., Jara-Quezada, L. J., et al. (2024) · Reumatología Clínica · doi:10.1016/j.reuma.2024.07.004 · Cited by 2 · see citing works
Lupus Pneumonitis Therapy Masks Coronavirus (COVID-19)
Soloway, S., DePace, N. L., Soloway, A. M., & Colombo, J. (2021) · Case Reports in Rheumatology · doi:10.1155/2021/6645780 · Cited by 2 · see citing works
“While there is no cure for lupus, current treatments focus on improving quality of life through controlling symptoms and minimizing flare-ups [8], including sun protection and diet, with anti-inflammatories and shortterm steroids [9, 10], and possibly immunosuppressive medications which may expedite the tapering or di…”
BackgroundNovel Therapeutic Interventions in Systemic Lupus Erythematosus
Athanassiou, P., Athanassiou, L., & Kostoglou‐Athanassiou, I. (2021) · IntechOpen eBooks · doi:10.5772/intechopen.97168 · Cited by 2 · see citing works
Pulmonary manifestations of systemic lupus erythematosus
Rodriguez, J. V., Doyle, T. J., & Dellaripa, P. F. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-820583-9.00037-3 · Cited by 2 · see citing works
Nirojini, P. S., Vijay, A., Raja, A. B., & Murugan, A. (2024) · Indian Journal of Pharmacy Practice · doi:10.5530/ijopp.17.2.16 · Cited by 2 · see citing works
“34 Prednisolone is administered intravenously during the acute phases; depending on the severity of the disease, prednisolone may then be gradually tapered off and replaced by an immunosuppressant or an antimalarial.”
26 Optimizing steroid-sparing drugs in SLE
Ruiz‐Irastorza, G. (2023) · doi:10.1136/lupus-2023-la.26 · Cited by 1 · see citing works
Patients’ Preferences for Systemic Lupus Erythematosus Treatments—A Discrete Choice Experiment
Collacott, H., Phillips-Beyer, A., Krucien, N., Flamion, B., & Marsh, K. (2024) · Patient · doi:10.1007/s40271-023-00670-7 · Cited by 1 · see citing works
“…are used in patients with SLE who do not respond well to anti-malarials or corticosteroids [6], and although they can have some steroid-sparing effects, they can also cause liver, gastrointestinal, and hematological side effects and increase the risk of infection and cancer [6, 7, 10].”
Clinical Practice Mexican Guidelines for the Treatment of Systemic Lupus Erythematosus: 2024 Update
Andrade-Ortega, L., Xibille-Friedmann, D. X., Galarza-Delgado, D. Á., Saavedra, M. Á., Álvarez-Nemegyei, J., Castañeda, M. C. A., Fragoso-Loyo, H. E., Gordillo-Huerta, M. V., Irazoque-Palazuelos, F. C., Jara-Quezada, L. J., et al. (2024) · Reumatología Clínica (English Edition) · doi:10.1016/j.reumae.2024.10.003 · Cited by 1 · see citing works
Joint Involvement in Systemic Lupus Erythematosus
Rossi, D., Modena, V., Bianchi, G., Pellerito, R., & Roccatello, D. (2016) · Rare diseases of the immune system · doi:10.1007/978-3-319-24535-5_6 · Cited by 1 · see citing works
Retinal Manifestations of the Rheumatic Diseases
Smith, W. M., & Rihani, H. T. (2022) · Springer eBooks · doi:10.1007/978-3-030-42634-7_16 · Cited by 1 · see citing works
Glucocorticoid-free Treatment of Systemic Lupus Erythematosus: Is it Feasible?
Shaharir, S. S., Gordon, C., & Reynolds, J. A. (2023) · Indian Journal of Rheumatology · doi:10.4103/injr.injr_97_22 · Cited by 1 · see citing works
“[57] Hence, EULAR has changed its recommendation from considering starting IS only in refractory or GC‑long‑term dependent patients in 2008, [36] to an early initiation of IS for a better control of disease with lower GC use in 2019.”
Drug Use in Systemic Lupus Erythematosus (SLE) Outpatients
N.Setiawati, M. C., Puspitaningrum, I., & Kertia, N. (2021) · Advances in health sciences research/Advances in Health Sciences Research · doi:10.2991/ahsr.k.210115.090
“Immunosuppressant shows its effectiveness and safeness for non-renal patient SLE [11].”
BackgroundProtocolo de manejo clínico del síndrome confusional en el lupus eritematoso sistémico
Hajkhan, A. M., Heras, C. B., Castañeda, N. G., & Gómez, A. P. (2021) · Medicine - Programa de Formación Médica Continuada Acreditado · doi:10.1016/j.med.2021.04.007
Retinal Manifestations of the Rheumatic Diseases
Smith, W. M., & Rihani, H. T. (2020) · Springer eBooks · doi:10.1007/978-3-319-90495-5_16-1
Northcott, M., & Morand, E. F. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-820583-9.00006-3
Bertolaccini, M. L. (2018) · Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature · doi:10.3410/f.727475988.793547379
Research Progress of Drug Therapy for Systemic Lupus Erythematosus
Tan, H. (2022) · Advances in Social Science, Education and Humanities Research/Advances in social science, education and humanities research · doi:10.2991/978-2-494069-31-2_64
Zhan, J., Fangqi, C., Jin, Y., Wang, Y., Ting, W., Cao, J., Zhang, J., & Changzheng, H. (2023) · Research Square · doi:10.21203/rs.3.rs-3230069/v1
27 Disease modification in lupus nephritis
Praga, M. (2023) · doi:10.1136/lupus-2023-la.27
25 Disease modification in SLE: an introduction
van Vollenhoven, R. (2023) · doi:10.1136/lupus-2023-la.25
Hao, Y., Hansen, D., Kandane‐Rathnayake, R., Louthrenoo, W., Chen, Y., Cho, J., Lateef, A., Hamijoyo, L., Luo, S., Wu, Y. J., et al. (2025) · Arthritis Care & Research · doi:10.1002/acr.25640
CAR T-cell therapy in systemic lupus erythematosus: a scoping review
Shumnalieva, R., Padjen, I., Monov, S. V., & Velikova, T. V. (2025) · Pharmacia · doi:10.3897/pharmacia.72.e167410
Case Report Bilateral Retinal Vasculitis: A Vision-threatening Flare of Systemic Lupus Erythematosus
Chandwani, L., Gollamudi, S., Magdum, R. M., & Yadav, H. (2026) · Annals of African Medicine · doi:10.4103/aam.aam_216_26
Ciosek, A., Hofmann, J., Galant, K., Marinkovich, M. P., Wierzbowska, A., Ciążyńska, M. A., Bień, N., Narbutt, J., & Lesiak, A. (2026) · Cells · doi:10.3390/cells15100874 · Cited by 1 · see citing works
“NSAIDs and low-dose aspirin provide symptomatic relief and thrombosis prevention [75,81,82].”
Eurasian Consensus of Rheumatologists on the diagnosis and treatment of systemic lupus erythematosus
Асылбекович, Т. Г., Baimukhamedov, C., Issayeva, B., Омарбекова, Ж. Е., Koilubaeva, G., Lobanchenko, O. V., Martusevich, N., Chizh, K. A., Shukurova, S. M., Haroyan, A. A., et al. (2026) · Rheumatology Science and Practice · doi:10.47360/1995-4484-2026-249-257
- Authors
- Pego‐Reigosa, J. M., Cobo‐Ibáñez, T., Calvo‐Alén, J., Loza‐Santamaría, E., Rahman, A., Muñoz‐Fernández, S., & Rúa‐Figueroa, Í.
- Affiliations
- University Hospital Complex Of Vigo (ES)
- Hospital Universitario Infanta Sofía (ES)
- Sierrallana Hospi‐ tal Torrelavega Spain
- Institute for Musculoskeletal Health Madrid Spain
- University College Hospital (GB)
- Hospital Universitario de Gran Canaria Doctor Negrín (ES)
- ORCID
- Venue
- Arthritis Care & Research
- Publisher
- Wiley
- Published
- 2013-11
- Volume
- 65
- Issue
- 11
- Pages
- 1775-1785
- ISSN
- 0893-7524 (ISSN-L)
- 2151-464X
- 2151-4658
- OpenAlex
- W1940577795
- Cited by
- 74
- References
- 83
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 10 · 2023: 9 · 2022: 4 · 2021: 9 · 2020: 5 · 2019: 5 · 2018: 5 · 2017: 3 · 2016: 9 · 2015: 2 · 2014: 3 · 2013: 2 · 2012: 1
- FWCI
- 0.85
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- Arthritis Care & Research (publishedVersion)
- PubMed (publishedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, other-oa)
- UCL Discovery (University College London) (submittedVersion)
- RUNA. Repositorio Institucional del Sergas (Servicio Gallego de Salud (SERGAS)) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Health Sciences › Medicine › Pathology and Forensic Medicine › Systemic Sclerosis and Related Diseases
- Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
- Keywords
- systemic lupus erythematosus, cyclophosphamide, methotrexate, azathioprine, leflunomide, mycophenolate mofetil, cyclosporine, steroid-sparing effect, relapse prevention, drug safety, drug efficacy, neuropsychiatric lupus
- MeSH terms
- Humans, Immunosuppressive Agents, Lupus Erythematosus, Systemic, Treatment Outcome
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