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Cited by 2,011Systemic Lupus Erythematosus ResearchSystemic Sclerosis and Related DiseasesVasculitis and related conditions

2019 update of the EULAR recommendations for the management of systemic lupus erythematosus

Open access
Fanouriakis, Antonis, Kostopoulou, Myrto, Alunno, Alessia, Aringer, Martin, Bajema, Ingeborg, Boletis, John N, Cervera, Ricard, Doria, Andrea +20 more·2019·Annals of the Rheumatic Diseases
DOI 10.1136/annrheumdis-2019-215089
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Abstract

Our objective was to update the EULAR recommendations for the management of systemic lupus erythematosus (SLE), based on emerging new evidence. We performed a systematic literature review (01/2007–12/2017), followed by modified Delphi method, to form questions, elicit expert opinions and reach consensus. Treatment in SLE aims at remission or low disease activity and prevention of flares. Hydroxychloroquine is recommended in all patients with lupus, at a dose not exceeding 5 mg/kg real body weight. During chronic maintenance treatment, glucocorticoids (GC) should be minimised to less than 7.5 mg/day (prednisone equivalent) and, when possible, withdrawn. Appropriate initiation of immunomodulatory agents (methotrexate, azathioprine, mycophenolate) can expedite the tapering/discontinuation of GC. In persistently active or flaring extrarenal disease, add-on belimumab should be considered; rituximab (RTX) may be considered in organ-threatening, refractory disease. Updated specific recommendations are also provided for cutaneous, neuropsychiatric, haematological and renal disease. Patients with SLE should be assessed for their antiphospholipid antibody status, infectious and cardiovascular diseases risk profile and preventative strategies be tailored accordingly. The updated recommendations provide physicians and patients with updated consensus guidance on the management of SLE, combining evidence-base and expert-opinion.

AI snapshot

Written from the paper’s full text.

TL;DR

This 2019 EULAR update provides consensus recommendations for managing systemic lupus erythematosus (SLE), based on a systematic literature review (2007–2017) and a Delphi process, yielding 33 final statements across goals of treatment, treatment, specific manifestations, and comorbidities. It emphasizes remission or low disease activity, hydroxychloroquine for all patients at ≤5 mg/kg real body weight, glucocorticoid minimization to <7.5 mg/day prednisone equivalent when possible, and add-on belimumab or rituximab in defined refractory settings.

Key findings

  • The Task Force reached consensus on 33 final statements; treatment should aim at remission or low disease activity and prevention of flares. Hydroxychloroquine (HCQ) is recommended for all patients with SLE unless contraindicated, at a dose not exceeding 5 mg/kg real body weight, with ophthalmological screening at baseline, after 5 years, and yearly thereafter in the absence of retinal toxicity risk factors.
  • For chronic maintenance, glucocorticoids should be minimized to less than 7.5 mg/day prednisone equivalent and withdrawn when possible; prompt initiation of immunomodulatory agents (methotrexate, azathioprine, mycophenolate) can expedite tapering/discontinuation. Add-on belimumab should be considered in extrarenal disease with inadequate response to standard care, and rituximab may be considered in organ-threatening, refractory disease.
  • In lupus nephritis, mycophenolate or low-dose intravenous cyclophosphamide are recommended for induction, and mycophenolate or azathioprine for maintenance; high-dose intravenous cyclophosphamide can also be used in patients at high risk for renal failure. Calcineurin inhibitors may be considered as second-line agents mainly in membranous lupus nephritis, podocytopathy, or refractory nephrotic syndrome.
  • All patients with SLE should be screened at diagnosis for antiphospholipid antibodies; infection and cardiovascular disease risk should be assessed and preventative strategies tailored. Low-dose aspirin may be considered for primary cardiovascular prevention (HR 0.24 in one retrospective study), but this must be balanced against bleeding hazard; routine statins are not recommended for all patients.

Methods

  • After EULAR Executive Committee approval, a Task Force performed an update using EULAR standardised operating procedures and AGREE II. A systematic literature review screened PubMed for English-language publications from 01/2007 to 12/2017, with two exceptions: skin disease had an unrestricted date search, and renal disease was limited to 01/2012–12/2017.
  • Fourteen research questions were selected via Delphi methodology; pertinent articles from manual reference-list searches were also included. Evidence was categorised by study design and validity, statements were graded, and after discussion rounds the committee reached consensus on 33 final statements, with each Task Force member rating agreement.

Limitations

  • The paper states several evidence gaps: data on optimal duration and timing of therapy discontinuation in renal and extrarenal disease are scarce; calcineurin inhibitor studies in lupus nephritis were performed almost exclusively in Asian populations and had short follow-up; no studies have been performed exclusively in patients with SLE-antiphospholipid syndrome; and no formal studies address low-molecular-weight heparin during high-risk periods. It also notes that HCQ efficacy was established at 6.5 mg/kg/day, so whether a lower dose has comparable clinical effects remains to be confirmed, and data are insufficient to recommend routine drug-level monitoring.
  • Evident from the text: the recommendations combine evidence and expert opinion, with many statements supported by low evidence grades (e.g., 4/C, 2b/C) and consensus agreement rather than high-quality randomized evidence. The systematic review ended in 12/2017, so later evidence is not incorporated.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1136/annrheumdis-2019-215089

Cites

162 of 162 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 43 cited sources checked · 0 supported · 0 flagged

  • Premisecitation

    In monitoring renal response, reduction of urinary protein following treatment is more important than residual haematuria.

    “In monitoring renal response, reduction of UPr (to less than 0.8 g/day) following treatment is more important than residual haematuria.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [21] Dall'Era, 2015, Predictors of long-term renal outcome in lupus nephritis trials: lessons learned from the Euro-Lupus nephritis cohort, Arthritis Rheumatol source

      Not checked in the free run.

  • Premisecitation

    The prevalence of retinal abnormalities exceeds 10% after 20 years of continuous hydroxychloroquine use.

    “a prevalence of retinal abnormalities exceeding 10% after 20 years of continuous use.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites 36 37

      Not checked in the free run.

  • Premisecitation

    Complete remission, defined as absence of clinical activity with no use of glucocorticoids and immunosuppressive drugs, is infrequent in SLE.

    “Complete remission (absence of clinical activity with no use of GC and IS drugs) is infrequent.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [12][13][14][15][16]

      Not checked in the free run.

  • Premisecitation

    Newly defined low disease activity states have shown comparable rates with remission regarding halting of damage accrual and prevention of flares.

    “newly defined low disease activity states (based on a SLEDAI score ≤3 on antimalarials, or alternatively SLEDAI ≤4, PGA≤1 with GC ≤7.5 mg of prednisone and well tolerated IS agents) have shown comparable rates with remission, regarding halting of damage accrual (OR 0.5-0.7 for increase in damage index) and prevention of flares.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites 14 17-20

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  • Premisecitation

    A posthoc analysis of the LUNAR trial showed that complete B-cell depletion following rituximab treatment in lupus nephritis was associated with higher odds for complete response at 78 weeks.

    “a posthoc analysis of the LUNAR trial showed that complete B-cell depletion following RTX treatment in LN was associated with higher odds for complete response at 78 weeks.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [78] Gomez Mendez, 2018, Peripheral blood B cell depletion after rituximab and complete response in lupus nephritis, Clin J Am Soc Nephrol source

      Not checked in the free run.

  • May combine two claims. 21
  • Classified as probably not a substantial claim. 9

  • May combine two claims.

    Premisecitation

    Risks of glucocorticoids are substantially increased at continuous doses above 7.5 mg/day, with some studies suggesting that also lower doses might be harmful.

    “Risks are substantially increased at continuous GC doses above 7.5 mg/day, with some studies suggesting that also lower doses might be harmful.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites 17 42-44

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    Premisecitation

    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.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [49] Pego-Reigosa, 2013, Efficacy and safety of nonbiologic immunosuppressants in the treatment of nonrenal systemic lupus erythematosus: a systematic review, Arthritis Care Res source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Distinction between inflammatory and embolic/thrombotic/ischaemic processes may not be easy in clinical practice, or the two processes may coexist in the same patient.

    “Distinction between the two pathophysiological processes may not be easy in clinical practice, or the two processes may coexist in the same patient.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [2] Bertsias, 2010, EULAR recommendations for the management of systemic lupus erythematosus with neuropsychiatric manifestations: report of a task Force of the EULAR standing Committee for clinical Affairs, Ann Rheum Dis source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Low-dose cyclophosphamide (Euro-Lupus regimen) is preferred over high-dose cyclophosphamide as it has comparable efficacy and lower risk of gonadotoxicity.

    “low-dose CYC (Euro-Lupus regimen, online supplementary table 5) is preferred over highdose CYC as it has comparable efficacy and lower risk of gonadotoxicity.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites 57 116 117

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  • May combine two claims.

    Interpretationreasoning

    Studies of calcineurin inhibitors for proliferative lupus nephritis were performed almost exclusively in Asian populations and had short follow-up; hence, data have to be corroborated with longer duration studies in multiethnic populations.

    “These studies were performed almost exclusively in Asian populations and had short follow-up; hence, data have to be corroborated with longer duration studies in multiethnic populations.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Each Task Force member rated their agreement with each statement.

    “Each Task Force member rated their agreement with each statement.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    The systematic literature review considered all English-language publications from 01/2007 until 12/2017, with exceptions for skin disease and renal disease.

    “the SLR considered all English-language publi- cations from 01/2007 until 12/2017, with two exceptions: (1) treatment of skin disease, where an unrestricted date search was performed and (2) renal disease, where search was limited to the period 01/2012-12/2017”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Patients with more severe proteinuria and longer-standing disease are less likely to respond or show more delayed responses.

    “Patients with more severe proteinuria and longerstanding disease are less likely to respond or show more delayed responses.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites 22 23

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  • May combine two claims.

    Premisecitation

    Rituximab has demonstrated efficacy both in lupus and in patients with isolated immune thrombocytopaenia.

    “RTX has demonstrated efficacy both in lupus and in patients with isolated immune thrombocytopaenia (ITP).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [74][75]5][76]

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  • Classified as probably not a substantial claim.

    Interpretationreasoning

    It remains to be confirmed whether a lower hydroxychloroquine dose will have comparable clinical effects.

    “it remains to be confirmed whether a lower dose will have comparable clinical effects.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Major risk factors for hydroxychloroquine retinopathy include duration of treatment, dose, chronic kidney disease and pre-existing retinal or macular disease.

    “Major risk factors for retinopathy include duration of treatment (OR 4.71 for every 5 years of use), dose (OR 3.34 for every 100 mg daily dose), chronic kidney disease (adjusted OR 8.56) and pre-existing retinal or macular disease.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [37] Kim, 2017, Risk of retinal toxicity in longterm users of hydroxychloroquine, J Rheumatol source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Mycophenolate mofetil is a potent immunosuppressant with efficacy in renal and non-renal lupus, although not in neuropsychiatric disease.

    “Mycophenolate mofetil (MMF) is a potent immunosuppressant with efficacy in renal and non-renal lupus (although not in neuropsychiatric disease).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [51][52][53]

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  • May combine two claims.

    Premisecitation

    Belimumab and rituximab have shown efficacy in mucocutaneous manifestations of SLE, although these studies have not included a validated activity score for skin lesions.

    “Belimumab and RTX have also shown efficacy in mucocutaneous manifestations of SLE, although these studies have not included a validated activity score for skin lesions”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites 62 92-94

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  • Classified as probably not a substantial claim.

    Premisecitation

    Treatment of neuropsychiatric SLE depends on whether the underlying pathophysiological mechanism is presumed to be inflammatory or embolic/thrombotic/ischaemic.

    “Treatment of NPSLE depends on whether the underlying pathophysiological mechanism is presumed to be inflammatory or embolic/thrombotic/ischaemic.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites 2 101

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    Premisecitation

    Flares are common in the disease course and contribute significantly to organ damage accrual and worse outcome.

    “Flares are common in the disease course and contribute significantly to organ damage accrual and worse outcome.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites 17 25 26

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  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductnone given

    The EULAR standardised operating procedures and the Appraisal of Guidelines Research and Evaluation instrument (AGREE II) were followed.

    “The EULAR standardised operating procedures 7 and the Appraisal of Guidelines Research and Evaluation instrument (AGREE II) 8 were followed.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Treatment of thrombocytopenia is typically lengthy and often characterised by relapses during glucocorticoid tapering.

    “Treatment of thrombocytopenia is typically lengthy and often characterised by relapses during GC tapering.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [109] Jung, 2016, Thrombocytopenia in systemic lupus erythematosus: clinical manifestations, treatment, and prognosis in 230 patients, Medicine source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Applying a Delphi-based methodology, 14 research questions were selected for the systematic literature review.

    “Applying a Delphi-based methodology, 14 research questions were selected for SLR (online supplementary table 1).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationnone given

    There are no studies examining retinal toxicity of quinacrine with newer sensitive screening techniques; however, with current knowledge, retinopathy is not considered a side-effect of quinacrine.

    “There are no studies examining retinal toxicity of quinacrine with the newer, more sensitive screening techniques (visual fields or optical coherence tomography); however with current knowledge, retinopathy is not considered a side-effect of quinacrine.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Mycophenolate or azathioprine may be used as maintenance therapy, with mycophenolate associated with fewer relapses.

    “MMF or AZA may be used as maintenance therapy, with the former associated with fewer relapses”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites 121 122

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Patients with persistent disease may benefit from belimumab; more likely to respond are patients with high disease activity, prednisone dose >7.5 mg/day and serological activity, with cutaneous, musculoskeletal and serological manifestations responding the most.

    “Patients with persistent disease may benefit from belimumab; more likely to respond are patients with high disease activity (eg, SLEDAI >10), prednisone dose >7.5 mg/day and serological activity (low C3/C4, high anti-dsDNA titres), with cutaneous, musculoskeletal and serological manifestations responding the most.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [67][68][69]

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    After rounds of discussions, the committee reached a consensus of 33 final statements.

    “After rounds of discussions, the committee reached a consensus of 33 final statements, grouped in four broad categories”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    It is not clear whether low-dose aspirin should be applied to patients with lupus with any antiphospholipid antibodies or only to those carrying a high-risk antiphospholipid profile.

    “it is not clear whether this should be applied to patients with lupus with any aPL antibodies or only to those carrying a high risk aPL profile”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    SLE is an independent risk factor for cardiovascular disease, due to both traditional and disease-related risk factors, such as persistent disease activity, lupus nephritis, presence of antiphospholipid antibodies and use of glucocorticoids.

    “SLE is an independent risk factor for cardiovascular disease (CVD), due to both traditional and disease-related risk factors, such as persistent disease activity, LN, presence of aPL and use of GC.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [147][148][149]

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Recent studies support the value of a repeat kidney biopsy for the management of maintenance therapy, but more data are needed.

    “recent studies support the value of a repeat kidney biopsy for the management of maintenance therapy, but more data are needed.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites 158 159

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  • May combine two claims.

    Interpretationnone given

    No studies have been performed exclusively on patients with SLE-APS, with several studies excluding secondary APS due to lupus.

    “No studies have been performed exclusively on patients with SLE-APS, with several studies excluding secondary APS due to lupus.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Risk of infection in SLE is associated with both disease-related and treatment-related factors; high-dose glucocorticoid therapy, cyclophosphamide, mycophenolate and rituximab are all associated with an increased risk for infection, while high disease activity, severe leucopaenia and presence of renal involvement also contribute independently.

    “Risk of infection in SLE is associated with both disease-related and treatment-related factors; high-dose GC therapy, CYC, MMF and RTX are all associated with an increased risk for infection, while high disease activity, severe leucopaenia and presence of renal involvement (±hypogammaglobulinaemia in nephrotic syndrome) also contribute independently.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites 48 140-143

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  • May combine two claims.

    Premisecitation

    The presence of antiphospholipid antibodies is associated with thrombotic and obstetric complications and increased risk of damage accrual.

    “The presence of aPL is associated with thrombotic and obstetric complications and increased risk of damage accrual.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites 133 134

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  • The paper relies on this without support.

    The evidence from studies in patients with cutaneous lupus erythematosus applies to skin disease in SLE.

    “A large body of evidence originates from studies in patients with cutaneous lupus erythematosus (CLE).”

  • The paper relies on this without support.

    The bleeding hazard from aspirin observed in diabetics and elderly applies to patients with SLE.

    “However, this has to be viewed in light of recent large studies in diabetics and elderly showing that the benefits of aspirin for primary CVD prevention are counterbalanced by the larger bleeding hazard.”

  • The paper relies on this without support.

    The results of the rivaroxaban versus warfarin trial in APS with triple antiphospholipid positivity apply to patients with SLE-APS.

    “A recent randomised, open-label trial comparing rivaroxaban to warfarin in APS with triple aPL positivity (~21% of patients had SLE-APS) was prematurely terminated due to an excess of thromboembolic events in the rivaroxaban arm.”
3 of 3

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Due to negative results of randomized controlled trials, rituximab is currently used off-label in SLE patients with severe renal or extrarenal disease refractory to other immunosuppressive agents and/or belimumab, or with contraindications to these drugs.

    “Due to the negative results of randomized, controlled trials (RCTs), RTX is currently only used off-label, in patients with severe renal or extrarenal (mainly hematological and neuropsychiatric) disease refractory to other IS agents and/or BLM, or in patients with contraindications to these drugs.73”

    From Autoimmune diseases and immune-checkpoint inhibitors for cancer therapy: Review of the literature and personalized risk-based prevention strategy (2020) · cites this paper as [73]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Conflicting glucocorticoid maintenance-dose limits

    Minor

    The abstract and recommendation table specify a maintenance dose of less than 7.5 mg/day, whereas the discussion permits doses up to and including 7.5 mg/day. They differ on whether exactly 7.5 mg/day meets the target.

1 of 1

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Authors
Fanouriakis, A., Kostopoulou, M., Alunno, A., Aringer, M., Bajema, I., Boletis, J. N., Cervera, R., Doria, A., Gordon, C., Govoni, M., Houssiau, F., Jayne, D., Kouloumas, M., Kuhn, A., Larsen, J. L., Lerstrøm, K., Moroni, G., Mosca, M., Schneider, M., Smolen, J. S., Svenungsson, E., Tesar, V., Tincani, A., Troldborg, A., van Vollenhoven, R., Wenzel, J., Bertsias, G., & Boumpas, D. T.
Affiliations
  • University General Hospital Attikon (GR)
  • General Hospital of Athens G. Genimatas (GR)
  • University of Perugia (IT)
  • University Hospital Carl Gustav Carus (DE)
  • Leiden University Medical Center (NL)
  • National and Kapodistrian University of Athens (GR)
  • Hospital Clínic de Barcelona (ES)
  • University of Padua (IT)
  • University of Birmingham (GB)
  • University of Ferrara (IT)
  • Cliniques Universitaires Saint-Luc (BE)
  • Addenbrooke's Hospital (GB)
  • University Hospital Münster (DE)
  • Rigshospitalet (DK)
  • Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT)
  • University of Pisa (IT)
  • Heinrich Heine University Düsseldorf (DE)
  • Medical University of Vienna (AT)
  • Karolinska University Hospital (SE)
  • Aarhus University Hospital (DK)
  • University Hospital of Heraklion (GR)
Corresponding author
Fanouriakis, Antonis
ORCID
Venue
Annals of the Rheumatic Diseases
Publisher
Elsevier BV
Published
2019-06
Volume
78
Issue
6
Pages
736-745
ISSN
0003-4967 (ISSN-L)
DOI
10.1136/annrheumdis-2019-215089
OpenAlex
W2927871970
Semantic Scholar
2a633e82de004894ad42e33a1bbbd71645ad7dd5
Cited by
2,011
References
162
Citations by year
2026: 132 · 2025: 189 · 2024: 322 · 2023: 349 · 2022: 347 · 2021: 317 · 2020: 271 · 2019: 77 · 2018: 1 · 2017: 2 · 2014: 1 · 2013: 1
FWCI
191.77
Type
journal article
Language
en
Open access
Licence
Locations
  • Annals of the Rheumatic Diseases (publishedVersion)
  • PubMed (publishedVersion)
  • Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
  • Institutional Research Information System University of Ferrara (University of Ferrara) (submittedVersion, other-oa)
  • Apollo (University of Cambridge) (submittedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • Leiden Repository (Leiden University) (submittedVersion)
  • CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion)
  • DIAL (Catholic University of Leuven) (submittedVersion, other-oa)
  • Institutional Research Information System (Università degli Studi di Brescia) (submittedVersion)
  • HighWire Press Open Archive (submittedVersion)
  • Pure Amsterdam UMC (submittedVersion, other-oa)
  • University of Birmingham Research Portal (University of Birmingham) (submittedVersion, other-oa)
  • Padua Research Archive (University of Padova) (submittedVersion)
  • Apollo
Funders
European League Against Rheumatism
Topics
  • Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Systemic Sclerosis and Related Diseases
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Vasculitis and related conditions
Keywords
systemic lupus erythematosus, lupus management, hydroxychloroquine, glucocorticoid tapering, immunomodulators, belimumab, rituximab, disease flares, cutaneous lupus erythematosus, neuropsychiatric lupus, renal lupus, antiphospholipid antibodies, cardiovascular risk, infectious disease risk, EULAR recommendations
MeSH terms
Biological Products, Glucocorticoids, Humans, Hydroxychloroquine, Immunosuppressive Agents, Lupus Erythematosus, Systemic, Severity of Illness Index, Comorbidity, Evidence-Based Medicine, Disease Management

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