Lupus & antiphospholipid syndrome
Management of systemic lupus erythematosus: a systematic literature review informing the 2023 update of the European League Against Rheumatism (EULAR) recommendations
Authors' conclusion
Anifrolumab and belimumab achieve better disease control than standard of care in extrarenal SLE, while combination therapies with belimumab and voclosporin attained higher response rates in high-quality RCTs in LN. Remission and low disease activity are associated with favourable long-term outcomes.
Study context
- Population
- Publications on management of systemic lupus erythematosus (SLE) (2018–2022), informing the 2023 update of the EULAR recommendations439 relevant articles
Methodological detailsEULAR standardised operating procedures, PICO framework, Medline and Cochrane Library, 1 January 2018 to 31 December 2022
- EULAR standardised operating procedures
- PICO framework
- Medline and Cochrane Library, 1 January 2018 to 31 December 2022
Main finding
As reported in the abstract
- High-quality randomised controlled trials (RCTs) documented efficacy of anifrolumab in non-renal SLE, and belimumab and voclosporin in lupus nephritis (LN), vs standard of care
- Lack of high-quality data for specific organ manifestations outside LN
- Multiple observational studies confirmed beneficial effects of attaining clinical remission or low disease activity, reducing risk of multiple adverse outcomes
- Two RCTs with some concerns regarding risk of bias found higher relapse rates after discontinuing glucocorticoids (GC) or immunosuppressants in SLE and LN, respectively; observational cohort studies suggest withdrawal might be feasible in a subset
- Majority observational studies of low or moderate quality
Original publication
Management of systemic lupus erythematosus: a systematic literature review informing the 2023 update of the EULAR recommendations. Ann Rheum Dis. Published 21 October 2024. doi:10.
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