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 Assessment of SLE Patients

  1. Clinical manifestations in SLE patients may be due to disease activity, damage, drug toxicity or the presence of co-morbidity. In the case of disease activity, it is important to ascertain whether this is due to active inflammation or thrombosis, as this will define treatment strategies (LOE 2 ++, GOR B, SOA 97%).

  2. Clinical assessment of a lupus patient should include a thorough history and review of systems, full clinical examination and monitoring of vital signs, urinalysis, laboratory tests, assessment of health status and quality of life, and measurement of disease activity and damage using standardized SLE assessment tools (2 ++/B). Imaging (4/D), renal (2 ++/B) and other biopsies (4/D) should be performed where indicated (SOA 100%).

  3. Disease activity is categorized into mild, moderate and severe, with the occurrence of flares (2+/C). Mild disease activity is clinically stable lupus with no life-threatening organ involvement, mainly manifesting as arthritis, mucocutaneous lesions and mild pleuritis. Patients with moderate disease activity have more serious manifestations, and severe disease is defined as organ- or life-threatening (4/D) (SOA 93%).