In a press release from the European Alliance of Associations for Rheumatology (EULAR), the organization provided updated recommendations on the management of patients with systemic lupus erythematosus. In a systematic literature review published by Fanouriakis et al in the Annals of the Rheumatic Diseases, an international, multidisciplinary taskforce comprised of patient research partners and health-care professionals analyzed emerging evidence from 2018 to 2022. They then formulated and evaluated the strength of the recommendations on the basis of participant agreement. The taskforce agreed on 5 overarching principles and 13 recommendations on the use of therapies (including hydroxychloroquine, glucocorticoids, immunosuppressants, calcineurin inhibitors, and biologics); therapeutic targets; response assessment; combination and sequential therapies; treatment tapering; kidney protection; and the prevention and treatment of comorbidities, such as osteoporosis and cardiovascular disease.
Highlights of the new recommendations include:
- Patients with lupus should receive 5 mg/kg of hydroxychloroquine daily
- Glucocorticoids can be used as bridging therapy during flare-ups and minimized to 5 mg or lower per day for maintenance therapy
- Immunosuppressants and biologics should be used to manage lupus and aid in the tapering or discontinuation of glucocorticoids.