EULAR recommendations for the management of systemic lupus erythematosus. Report of a Task Force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics
Identifieur interne : 002032 ( Istex/Corpus ); précédent : 002031; suivant : 002033EULAR recommendations for the management of systemic lupus erythematosus. Report of a Task Force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics
Auteurs : G. Bertsias ; J P A. Ioannidis ; J. Boletis ; S. Bombardieri ; R. Cervera ; C. Dostal ; J. Font ; I M Gilboe ; F. Houssiau ; T. Huizinga ; D. Isenberg ; C G M. Kallenberg ; M. Khamashta ; J C Piette ; M. Schneider ; J. Smolen ; G. Sturfelt ; A. Tincani ; R. Van Vollenhoven ; C. Gordon ; D T BoumpasSource :
- Annals of the Rheumatic Diseases [ 0003-4967 ] ; 2008-02.
English descriptors
- Teeft :
- Antiphospholipid, Antiphospholipid antibodies, Antiphospholipid syndrome, Arthritis, Arthritis rheum, Aspirin, Azathioprine, Boumpas, Cohort, Cyclophosphamide, Damage accrual, Disease activity, Engl, Erythematosus, Eular, Expert committee, Expert opinion, Fetal, Gladman, Glucocorticoid, Hydroxychloroquine, Immunosuppressive, Induction therapy, Intravenous, Lupus, Lupus erythematosus, Lupus nephritis, Lupus pregnancy, Mofetil, Morbidity, Mycophenolate, Mycophenolate mofetil, Nephritis, Neuropsychiatric, Neuropsychiatric lupus, Neuropsychiatric manifestations, Oral anticoagulation, Osteoporosis, Predictor, Pregnancy, Pregnancy loss, Prognostic, Proliferative, Proliferative lupus nephritis, Prospective study, Randomised trials, Randomized, Recurrent thrombosis, Relapse, Renal, Renal disease, Renal transplantation, Rheum, Rheumatol, Rheumatology, Risk factors, Syndrome, Systemic, Systemic lupus erythematosus, Thrombosis, Transplantation, Urowitz.
Abstract
Objective: Systemic lupus erythematosus (SLE) is a complex disease with variable presentations, course and prognosis. We sought to develop evidence-based recommendations addressing the major issues in the management of SLE. Methods: The EULAR Task Force on SLE comprised 19 specialists and a clinical epidemiologist. Key questions for the management of SLE were compiled using the Delphi technique. A systematic search of PubMed and Cochrane Library Reports was performed using McMaster/Hedges clinical queries’ strategies for questions related to the diagnosis, prognosis, monitoring and treatment of SLE. For neuropsychiatric, pregnancy and antiphospholipid syndrome questions, the search was conducted using an array of relevant terms. Evidence was categorised based on sample size and type of design, and the categories of available evidence were identified for each recommendation. The strength of recommendation was assessed based on the category of available evidence, and agreement on the statements was measured across the 19 specialists. Results: Twelve questions were generated regarding the prognosis, diagnosis, monitoring and treatment of SLE, including neuropsychiatric SLE, pregnancy, the antiphospholipid syndrome and lupus nephritis. The evidence to support each proposition was evaluated and scored. After discussion and votes, the final recommendations were presented using brief statements. The average agreement among experts was 8.8 out of 10. Conclusion: Recommendations for the management of SLE were developed using an evidence-based approach followed by expert consensus with high level of agreement among the experts.
Url:
DOI: 10.1136/ard.2007.070367
Links to Exploration step
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<author><name sortKey="Kallenberg, C G M" sort="Kallenberg, C G M" uniqKey="Kallenberg C" first="C G M" last="Kallenberg">C G M. Kallenberg</name>
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<author><name sortKey="Piette, J C" sort="Piette, J C" uniqKey="Piette J" first="J C" last="Piette">J C Piette</name>
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<author><name sortKey="Sturfelt, G" sort="Sturfelt, G" uniqKey="Sturfelt G" first="G" last="Sturfelt">G. Sturfelt</name>
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<sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">EULAR recommendations for the management of systemic lupus erythematosus. Report of a Task Force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics</title>
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<author><name sortKey="Ioannidis, J P A" sort="Ioannidis, J P A" uniqKey="Ioannidis J" first="J P A" last="Ioannidis">J P A. Ioannidis</name>
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<author><name sortKey="Boletis, J" sort="Boletis, J" uniqKey="Boletis J" first="J" last="Boletis">J. Boletis</name>
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<author><name sortKey="Bombardieri, S" sort="Bombardieri, S" uniqKey="Bombardieri S" first="S" last="Bombardieri">S. Bombardieri</name>
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<author><name sortKey="Cervera, R" sort="Cervera, R" uniqKey="Cervera R" first="R" last="Cervera">R. Cervera</name>
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<author><name sortKey="Dostal, C" sort="Dostal, C" uniqKey="Dostal C" first="C" last="Dostal">C. Dostal</name>
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<author><name sortKey="Font, J" sort="Font, J" uniqKey="Font J" first="J" last="Font">J. Font</name>
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<author><name sortKey="Gilboe, I M" sort="Gilboe, I M" uniqKey="Gilboe I" first="I M" last="Gilboe">I M Gilboe</name>
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<author><name sortKey="Houssiau, F" sort="Houssiau, F" uniqKey="Houssiau F" first="F" last="Houssiau">F. Houssiau</name>
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<author><name sortKey="Huizinga, T" sort="Huizinga, T" uniqKey="Huizinga T" first="T" last="Huizinga">T. Huizinga</name>
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<author><name sortKey="Isenberg, D" sort="Isenberg, D" uniqKey="Isenberg D" first="D" last="Isenberg">D. Isenberg</name>
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<author><name sortKey="Kallenberg, C G M" sort="Kallenberg, C G M" uniqKey="Kallenberg C" first="C G M" last="Kallenberg">C G M. Kallenberg</name>
<affiliation><mods:affiliation>Department of Clinical Immunology, University Medical Center Groningen, Groningen, The Netherlands</mods:affiliation>
</affiliation>
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<author><name sortKey="Khamashta, M" sort="Khamashta, M" uniqKey="Khamashta M" first="M" last="Khamashta">M. Khamashta</name>
<affiliation><mods:affiliation>Lupus Research Unit, The Rayne Institute, St Thomas’ Hospital, London, UK</mods:affiliation>
</affiliation>
</author>
<author><name sortKey="Piette, J C" sort="Piette, J C" uniqKey="Piette J" first="J C" last="Piette">J C Piette</name>
<affiliation><mods:affiliation>Service de Médecine Interne, Groupe Hospitalier Pitié-Salpêtrière, Paris, France</mods:affiliation>
</affiliation>
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<author><name sortKey="Schneider, M" sort="Schneider, M" uniqKey="Schneider M" first="M" last="Schneider">M. Schneider</name>
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</affiliation>
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<author><name sortKey="Smolen, J" sort="Smolen, J" uniqKey="Smolen J" first="J" last="Smolen">J. Smolen</name>
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</affiliation>
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<author><name sortKey="Sturfelt, G" sort="Sturfelt, G" uniqKey="Sturfelt G" first="G" last="Sturfelt">G. Sturfelt</name>
<affiliation><mods:affiliation>Department of Rheumatology, University Hospital of Lund, Lund, Sweden</mods:affiliation>
</affiliation>
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<author><name sortKey="Tincani, A" sort="Tincani, A" uniqKey="Tincani A" first="A" last="Tincani">A. Tincani</name>
<affiliation><mods:affiliation>Rheumatologia e Immunologia Clinica, Ospedale Civile di Brescia, Italy</mods:affiliation>
</affiliation>
</author>
<author><name sortKey="Van Vollenhoven, R" sort="Van Vollenhoven, R" uniqKey="Van Vollenhoven R" first="R" last="Van Vollenhoven">R. Van Vollenhoven</name>
<affiliation><mods:affiliation>Rheumatology Unit, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden</mods:affiliation>
</affiliation>
</author>
<author><name sortKey="Gordon, C" sort="Gordon, C" uniqKey="Gordon C" first="C" last="Gordon">C. Gordon</name>
<affiliation><mods:affiliation>Centre for Immune Regulation, Division of Immunity and Infection, The University of Birmingham, Birmingham, UK</mods:affiliation>
</affiliation>
</author>
<author><name sortKey="Boumpas, D T" sort="Boumpas, D T" uniqKey="Boumpas D" first="D T" last="Boumpas">D T Boumpas</name>
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<term>Antiphospholipid antibodies</term>
<term>Antiphospholipid syndrome</term>
<term>Arthritis</term>
<term>Arthritis rheum</term>
<term>Aspirin</term>
<term>Azathioprine</term>
<term>Boumpas</term>
<term>Cohort</term>
<term>Cyclophosphamide</term>
<term>Damage accrual</term>
<term>Disease activity</term>
<term>Engl</term>
<term>Erythematosus</term>
<term>Eular</term>
<term>Expert committee</term>
<term>Expert opinion</term>
<term>Fetal</term>
<term>Gladman</term>
<term>Glucocorticoid</term>
<term>Hydroxychloroquine</term>
<term>Immunosuppressive</term>
<term>Induction therapy</term>
<term>Intravenous</term>
<term>Lupus</term>
<term>Lupus erythematosus</term>
<term>Lupus nephritis</term>
<term>Lupus pregnancy</term>
<term>Mofetil</term>
<term>Morbidity</term>
<term>Mycophenolate</term>
<term>Mycophenolate mofetil</term>
<term>Nephritis</term>
<term>Neuropsychiatric</term>
<term>Neuropsychiatric lupus</term>
<term>Neuropsychiatric manifestations</term>
<term>Oral anticoagulation</term>
<term>Osteoporosis</term>
<term>Predictor</term>
<term>Pregnancy</term>
<term>Pregnancy loss</term>
<term>Prognostic</term>
<term>Proliferative</term>
<term>Proliferative lupus nephritis</term>
<term>Prospective study</term>
<term>Randomised trials</term>
<term>Randomized</term>
<term>Recurrent thrombosis</term>
<term>Relapse</term>
<term>Renal</term>
<term>Renal disease</term>
<term>Renal transplantation</term>
<term>Rheum</term>
<term>Rheumatol</term>
<term>Rheumatology</term>
<term>Risk factors</term>
<term>Syndrome</term>
<term>Systemic</term>
<term>Systemic lupus erythematosus</term>
<term>Thrombosis</term>
<term>Transplantation</term>
<term>Urowitz</term>
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<front><div type="abstract">Objective: Systemic lupus erythematosus (SLE) is a complex disease with variable presentations, course and prognosis. We sought to develop evidence-based recommendations addressing the major issues in the management of SLE. Methods: The EULAR Task Force on SLE comprised 19 specialists and a clinical epidemiologist. Key questions for the management of SLE were compiled using the Delphi technique. A systematic search of PubMed and Cochrane Library Reports was performed using McMaster/Hedges clinical queries’ strategies for questions related to the diagnosis, prognosis, monitoring and treatment of SLE. For neuropsychiatric, pregnancy and antiphospholipid syndrome questions, the search was conducted using an array of relevant terms. Evidence was categorised based on sample size and type of design, and the categories of available evidence were identified for each recommendation. The strength of recommendation was assessed based on the category of available evidence, and agreement on the statements was measured across the 19 specialists. Results: Twelve questions were generated regarding the prognosis, diagnosis, monitoring and treatment of SLE, including neuropsychiatric SLE, pregnancy, the antiphospholipid syndrome and lupus nephritis. The evidence to support each proposition was evaluated and scored. After discussion and votes, the final recommendations were presented using brief statements. The average agreement among experts was 8.8 out of 10. Conclusion: Recommendations for the management of SLE were developed using an evidence-based approach followed by expert consensus with high level of agreement among the experts.</div>
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<abstract>Objective: Systemic lupus erythematosus (SLE) is a complex disease with variable presentations, course and prognosis. We sought to develop evidence-based recommendations addressing the major issues in the management of SLE. Methods: The EULAR Task Force on SLE comprised 19 specialists and a clinical epidemiologist. Key questions for the management of SLE were compiled using the Delphi technique. A systematic search of PubMed and Cochrane Library Reports was performed using McMaster/Hedges clinical queries’ strategies for questions related to the diagnosis, prognosis, monitoring and treatment of SLE. For neuropsychiatric, pregnancy and antiphospholipid syndrome questions, the search was conducted using an array of relevant terms. Evidence was categorised based on sample size and type of design, and the categories of available evidence were identified for each recommendation. The strength of recommendation was assessed based on the category of available evidence, and agreement on the statements was measured across the 19 specialists. Results: Twelve questions were generated regarding the prognosis, diagnosis, monitoring and treatment of SLE, including neuropsychiatric SLE, pregnancy, the antiphospholipid syndrome and lupus nephritis. The evidence to support each proposition was evaluated and scored. After discussion and votes, the final recommendations were presented using brief statements. The average agreement among experts was 8.8 out of 10. Conclusion: Recommendations for the management of SLE were developed using an evidence-based approach followed by expert consensus with high level of agreement among the experts.</abstract>
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<article-id pub-id-type="other">annrheumdis;67/2/195</article-id>
<article-id pub-id-type="other">annrheumdis;ard.2007.070367</article-id>
<article-id pub-id-type="pmid">17504841</article-id>
<article-id pub-id-type="other">195</article-id>
<article-id pub-id-type="other">ard.2007.070367</article-id>
<article-categories><subj-group subj-group-type="heading"><subject content-type="original">Extended reports</subject>
</subj-group>
<subj-group subj-group-type="hwp-journal-coll"><subject>Unlocked</subject>
</subj-group>
<subj-group subj-group-type="hwp-journal-coll"><subject>Immunology (including allergy)</subject>
</subj-group>
<subj-group subj-group-type="hwp-journal-coll"><subject>Renal medicine</subject>
</subj-group>
<subj-group subj-group-type="hwp-journal-coll"><subject>Connective tissue disease</subject>
</subj-group>
<subj-group subj-group-type="hwp-journal-coll"><subject>Systemic lupus erythematosus</subject>
</subj-group>
</article-categories>
<title-group><article-title>EULAR recommendations for the management of systemic lupus erythematosus. Report of a Task Force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics</article-title>
<alt-title alt-title-type="running-head">Extended report</alt-title>
</title-group>
<contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Bertsias</surname>
<given-names>G</given-names>
</name>
<xref ref-type="aff" rid="aff1">1</xref>
</contrib>
<contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Ioannidis</surname>
<given-names>J P A</given-names>
</name>
<xref ref-type="aff" rid="aff2">2</xref>
</contrib>
<contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Boletis</surname>
<given-names>J</given-names>
</name>
<xref ref-type="aff" rid="aff3">3</xref>
</contrib>
<contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Bombardieri</surname>
<given-names>S</given-names>
</name>
<xref ref-type="aff" rid="aff4">4</xref>
</contrib>
<contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Cervera</surname>
<given-names>R</given-names>
</name>
<xref ref-type="aff" rid="aff5">5</xref>
</contrib>
<contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Dostal</surname>
<given-names>C</given-names>
</name>
<xref ref-type="aff" rid="aff6">6</xref>
</contrib>
<contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Font</surname>
<given-names>J</given-names>
</name>
<xref ref-type="aff" rid="aff5">5</xref>
</contrib>
<contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Gilboe</surname>
<given-names>I M</given-names>
</name>
<xref ref-type="aff" rid="aff7">7</xref>
</contrib>
<contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Houssiau</surname>
<given-names>F</given-names>
</name>
<xref ref-type="aff" rid="aff8">8</xref>
</contrib>
<contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Huizinga</surname>
<given-names>T</given-names>
</name>
<xref ref-type="aff" rid="aff9">9</xref>
</contrib>
<contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Isenberg</surname>
<given-names>D</given-names>
</name>
<xref ref-type="aff" rid="aff10">10</xref>
</contrib>
<contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Kallenberg</surname>
<given-names>C G M</given-names>
</name>
<xref ref-type="aff" rid="aff11">11</xref>
</contrib>
<contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Khamashta</surname>
<given-names>M</given-names>
</name>
<xref ref-type="aff" rid="aff12">12</xref>
</contrib>
<contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Piette</surname>
<given-names>J C</given-names>
</name>
<xref ref-type="aff" rid="aff13">13</xref>
</contrib>
<contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Schneider</surname>
<given-names>M</given-names>
</name>
<xref ref-type="aff" rid="aff14">14</xref>
</contrib>
<contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Smolen</surname>
<given-names>J</given-names>
</name>
<xref ref-type="aff" rid="aff15">15</xref>
</contrib>
<contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Sturfelt</surname>
<given-names>G</given-names>
</name>
<xref ref-type="aff" rid="aff16">16</xref>
</contrib>
<contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Tincani</surname>
<given-names>A</given-names>
</name>
<xref ref-type="aff" rid="aff17">17</xref>
</contrib>
<contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>van Vollenhoven</surname>
<given-names>R</given-names>
</name>
<xref ref-type="aff" rid="aff18">18</xref>
</contrib>
<contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Gordon</surname>
<given-names>C</given-names>
</name>
<xref ref-type="aff" rid="aff19">19</xref>
</contrib>
<contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Boumpas</surname>
<given-names>D T</given-names>
</name>
<xref ref-type="aff" rid="aff1">1</xref>
</contrib>
</contrib-group>
<aff id="aff1"><label>1</label>
<addr-line>Internal Medicine, and Rheumatology, Clinical Immunology and Allergy, University of Crete School of Medicine, Heraklion, Greece</addr-line>
</aff>
<aff id="aff2"><label>2</label>
<addr-line>Clinical Trials and Evidence-Based Medicine Unit, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece</addr-line>
</aff>
<aff id="aff3"><label>3</label>
<addr-line>Department of Nephrology and Transplantation Medicine, Laiko Hospital, Athens, Greece</addr-line>
</aff>
<aff id="aff4"><label>4</label>
<addr-line>Cattedra di Reumatologia, Universita di Pisa, Pisa, Italy</addr-line>
</aff>
<aff id="aff5"><label>5</label>
<addr-line>Department of Autoimmune Diseases, Hospital Clinic, Barcelona, Spain</addr-line>
</aff>
<aff id="aff6"><label>6</label>
<addr-line>Institute of Rheumatology, Prague, Czech Republic</addr-line>
</aff>
<aff id="aff7"><label>7</label>
<addr-line>Department of Rheumatology, Rikshospitalet, Oslo, Norway</addr-line>
</aff>
<aff id="aff8"><label>8</label>
<addr-line>Rheumatology Department, Université catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium</addr-line>
</aff>
<aff id="aff9"><label>9</label>
<addr-line>Department of Rheumatology Leiden University Medical Center, Leiden, The Netherlands</addr-line>
</aff>
<aff id="aff10"><label>10</label>
<addr-line>Centre for Rheumatology, University College London Hospitals, London, UK</addr-line>
</aff>
<aff id="aff11"><label>11</label>
<addr-line>Department of Clinical Immunology, University Medical Center Groningen, Groningen, The Netherlands</addr-line>
</aff>
<aff id="aff12"><label>12</label>
<addr-line>Lupus Research Unit, The Rayne Institute, St Thomas’ Hospital, London, UK</addr-line>
</aff>
<aff id="aff13"><label>13</label>
<addr-line>Service de Médecine Interne, Groupe Hospitalier Pitié-Salpêtrière, Paris, France</addr-line>
</aff>
<aff id="aff14"><label>14</label>
<addr-line>Rheumatolology, Clinic of Endocrinology, Diabetology and Rheumatology, Heinrich-Heine-University, Dusseldorf, Germany</addr-line>
</aff>
<aff id="aff15"><label>15</label>
<addr-line>Department of Rheumatology, Medical University of Vienna, Austria</addr-line>
</aff>
<aff id="aff16"><label>16</label>
<addr-line>Department of Rheumatology, University Hospital of Lund, Lund, Sweden</addr-line>
</aff>
<aff id="aff17"><label>17</label>
<addr-line>Rheumatologia e Immunologia Clinica, Ospedale Civile di Brescia, Italy</addr-line>
</aff>
<aff id="aff18"><label>18</label>
<addr-line>Rheumatology Unit, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden</addr-line>
</aff>
<aff id="aff19"><label>19</label>
<addr-line>Centre for Immune Regulation, Division of Immunity and Infection, The University of Birmingham, Birmingham, UK</addr-line>
</aff>
<author-notes><corresp>D T Boumpas, Departments of Internal Medicine and Rheumatology, University of Crete School of Medicine, 71003, Heraklion, Greece; <email xlink:type="simple">boumpasd@med.uoc.gr</email>
</corresp>
<fn fn-type="other"><p>This is an abbreviated version of the recommendations. The full-text version is available online (<ext-link ext-link-type="uri" xlink:href="http://ard.bmj.com" xlink:type="simple">http://ard.bmj.com</ext-link>
)</p>
</fn>
<fn fn-type="other"><p>Dr Font died on 26 July 2006.</p>
</fn>
</author-notes>
<pub-date pub-type="ppub"><month>2</month>
<year>2008</year>
</pub-date>
<pub-date pub-type="epub-original"><day>5</day>
<month>7</month>
<year>2007</year>
</pub-date>
<pub-date pub-type="epub"><day>15</day>
<month>5</month>
<year>2007</year>
</pub-date>
<volume>67</volume>
<volume-id pub-id-type="other">67</volume-id>
<volume-id pub-id-type="other">67</volume-id>
<issue>2</issue>
<issue-id pub-id-type="other">annrheumdis;67/2</issue-id>
<issue-id pub-id-type="other">2</issue-id>
<issue-id pub-id-type="other">67/2</issue-id>
<fpage>195</fpage>
<history><date date-type="accepted"><day>30</day>
<month>4</month>
<year>2007</year>
</date>
</history>
<permissions><copyright-statement>2008 BMJ Publishing Group and European League Against Rheumatism</copyright-statement>
<copyright-year>2008</copyright-year>
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<self-uri content-type="pdf" xlink:role="full-text" xlink:href="annrheumdis-67-195.pdf"></self-uri>
<abstract><sec><title>Objective:</title>
<p>Systemic lupus erythematosus (SLE) is a complex disease with variable presentations, course and prognosis. We sought to develop evidence-based recommendations addressing the major issues in the management of SLE.</p>
</sec>
<sec><title>Methods:</title>
<p>The EULAR Task Force on SLE comprised 19 specialists and a clinical epidemiologist. Key questions for the management of SLE were compiled using the Delphi technique. A systematic search of PubMed and Cochrane Library Reports was performed using McMaster/Hedges clinical queries’ strategies for questions related to the diagnosis, prognosis, monitoring and treatment of SLE. For neuropsychiatric, pregnancy and antiphospholipid syndrome questions, the search was conducted using an array of relevant terms. Evidence was categorised based on sample size and type of design, and the categories of available evidence were identified for each recommendation. The strength of recommendation was assessed based on the category of available evidence, and agreement on the statements was measured across the 19 specialists.</p>
</sec>
<sec><title>Results:</title>
<p>Twelve questions were generated regarding the prognosis, diagnosis, monitoring and treatment of SLE, including neuropsychiatric SLE, pregnancy, the antiphospholipid syndrome and lupus nephritis. The evidence to support each proposition was evaluated and scored. After discussion and votes, the final recommendations were presented using brief statements. The average agreement among experts was 8.8 out of 10.</p>
</sec>
<sec><title>Conclusion:</title>
<p>Recommendations for the management of SLE were developed using an evidence-based approach followed by expert consensus with high level of agreement among the experts.</p>
</sec>
</abstract>
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<name type="personal"><namePart type="given">J P A</namePart>
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<name type="personal"><namePart type="given">S</namePart>
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<name type="personal"><namePart type="given">T</namePart>
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<name type="personal"><namePart type="given">C G M</namePart>
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<name type="personal"><namePart type="given">M</namePart>
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<affiliation>Department of Rheumatology, Medical University of Vienna, Austria</affiliation>
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<name type="personal"><namePart type="given">G</namePart>
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<name type="personal"><namePart type="given">R</namePart>
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<name type="personal"><namePart type="given">C</namePart>
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<name type="personal"><namePart type="given">D T</namePart>
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<abstract>Objective: Systemic lupus erythematosus (SLE) is a complex disease with variable presentations, course and prognosis. We sought to develop evidence-based recommendations addressing the major issues in the management of SLE. Methods: The EULAR Task Force on SLE comprised 19 specialists and a clinical epidemiologist. Key questions for the management of SLE were compiled using the Delphi technique. A systematic search of PubMed and Cochrane Library Reports was performed using McMaster/Hedges clinical queries’ strategies for questions related to the diagnosis, prognosis, monitoring and treatment of SLE. For neuropsychiatric, pregnancy and antiphospholipid syndrome questions, the search was conducted using an array of relevant terms. Evidence was categorised based on sample size and type of design, and the categories of available evidence were identified for each recommendation. The strength of recommendation was assessed based on the category of available evidence, and agreement on the statements was measured across the 19 specialists. Results: Twelve questions were generated regarding the prognosis, diagnosis, monitoring and treatment of SLE, including neuropsychiatric SLE, pregnancy, the antiphospholipid syndrome and lupus nephritis. The evidence to support each proposition was evaluated and scored. After discussion and votes, the final recommendations were presented using brief statements. The average agreement among experts was 8.8 out of 10. Conclusion: Recommendations for the management of SLE were developed using an evidence-based approach followed by expert consensus with high level of agreement among the experts.</abstract>
<note type="footnotes">This is an abbreviated version of the recommendations. The full-text version is available online (http://ard.bmj.com)</note>
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