The British Society for Rheumatology Guideline for the Management of Systemic Lupus Erythematosus in Adults

Caroline Gordon; Maame-Boatemaa Amissah-Arthur; Mary Gayed; Sue Brown; Ian N. Bruce; David D'Cruz; Benjamin Empson; Bridget Griffiths; David Jayne; Munther Khamashta; Liz Lightstone; Peter Norton; Yvonne Norton; Karen Schreiber; David Isenberg


Rheumatology. 2018;57(1):e1-e45. 

In This Article

Recommendations for the Management of Moderate SLE

  1. The management of moderate SLE involves higher doses of prednisolone (up to 0.5 mg/kg/day) (2+/C), or the use of i.m. (4/D) or i.v. doses of methylprednisolone (MP) (2+/C). Immunosuppressive agents are often required to control active disease and are steroid-sparing agents (2+/C). They can also reduce the risk of long-term damage accrual (4/D) (SOA 98%).

  2. MTX (1+/A), AZA (2+/C), MMF (2 ++/B), ciclosporin (2+/C) and other calcineurin inhibitors (3/D) should be considered in cases of arthritis, cutaneous disease, serositis, vasculitis or cytopaenias if HCQ is insufficient (SOA 97%).

  3. For refractory cases, belimumab (1+/B) or rituximab (2+/C) may be considered (SOA 98%).