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

The Guideline

Eligibility Criteria

This guideline is designed to cover the management of adult patients with SLE by healthcare professionals. These recommendations are based on the literature review covering the diagnosis, assessment, monitoring and treatment of mild, moderate and severe lupus, including neuropsychiatric (NP) disease. The focus of the literature review was on non-renal disease, as the EULAR/ERA-EDTA recommendations for LN (see below) were published[24] close to the time that we started work on this guideline.

Exclusion Criteria

Management of paediatric lupus, renal lupus, topical treatment for cutaneous lupus, and drug treatment in pregnancy have been excluded from our literature search and guideline development. BSR guidelines on the use of drugs in pregnant patients with rheumatic diseases (including lupus) have been developed in parallel with this guideline.

Introduction to the Recommendations and Supporting Evidence

For each question addressed by the literature review (supplementary data section Search strategy, available at Rheumatology Online), we provide first the recommendations and the overall LOE, GOR and SOA for each, followed by the rationale. The rationale consists of a summary of the evidence supporting the statements (including cautions in the case of drug therapy). It is organized by topic and includes some key points about the studies leading to the recommendations and a conclusion for each topic discussed. The number of studies and types of studies (with references) leading to the LOE and GOR are summarized in Table 1 for the items contributing to the recommendations on diagnosis, assessment and monitoring of lupus, and in Table 2 for those relating to the treatment and prevention of mild, moderate and severe non-renal lupus. In Table 3 we provide our SOA with key points of the EULAR/ERA-EDTA recommendations for the management of LN,[24] so that the management of the most important aspects of lupus are covered by this guideline in a single document.