2019 update of the EULAR recommendations for the management of systemic lupus erythematosus
Jazyk angličtina Země Spojené státy americké Médium print-electronic
Typ dokumentu časopisecké články, směrnice pro lékařskou praxi, práce podpořená grantem
PubMed
30926722
DOI
10.1136/annrheumdis-2019-215089
PII: S0003-4967(24)00642-3
Knihovny.cz E-zdroje
- Klíčová slova
- lupus nephritis, systemic lupus erythematosus, treatment,
- MeSH
- biologické přípravky terapeutické užití MeSH
- glukokortikoidy terapeutické užití MeSH
- hydroxychlorochin terapeutické užití MeSH
- imunosupresiva terapeutické užití MeSH
- komorbidita MeSH
- lidé MeSH
- management nemoci MeSH
- medicína založená na důkazech metody MeSH
- stupeň závažnosti nemoci MeSH
- systémový lupus erythematodes komplikace farmakoterapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- směrnice pro lékařskou praxi MeSH
- Názvy látek
- biologické přípravky MeSH
- glukokortikoidy MeSH
- hydroxychlorochin MeSH
- imunosupresiva MeSH
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treatment, glucocorticoids (GC) should be minimised to less than 7.5 mg/day (prednisone equivalent) and, when possible, withdrawn.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.
Cliniques Universitaires Saint Luc Université catholique de Louvain Brussels Belgium
Cyprus League Against Rheumatism Aglantzia Cyprus
Department of Autoimmune Diseases Hospital Clinic Barcelona Spain
Department of Dermatology and Allergy University Hospital Bonn Bonn Germany
Department of Medicine Addenbrooke's Hospital Cambridge UK
Department of Nephrology G Gennimatas General Hospital Athens Greece
Department of Pathology Leiden University Medical Center Leiden Netherlands
Department of Rheumatology Aarhus University Hospital Aarhus Denmark
Division of Rheumatology Department of Medicine 3 Medical University of Vienna Vienna Austria
Nephrology Unit Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milan Italy
Rheumatology and Clinical Immunology Unit Attikon University Hospital Athens Greece
Rheumatology and Clinical Immunology University of Brescia Brescia Italy
Rheumatology Clinical Immunology and Allergy University Hospital of Heraklion Heraklion Greece
Rheumatology Unit Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
Rheumatology Unit Department of Medicine University of Padova Padova Italy
Rheumatology Unit Department of Medicine University of Perugia Perugia Italy
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