Article Text

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
  1. G Bertsias1,
  2. J P A Ioannidis2,
  3. J Boletis3,
  4. S Bombardieri4,
  5. R Cervera5,
  6. C Dostal6,
  7. J Font5,
  8. I M Gilboe7,
  9. F Houssiau8,
  10. T Huizinga9,
  11. D Isenberg10,
  12. C G M Kallenberg11,
  13. M Khamashta12,
  14. J C Piette13,
  15. M Schneider14,
  16. J Smolen15,
  17. G Sturfelt16,
  18. A Tincani17,
  19. R van Vollenhoven18,
  20. C Gordon19,
  21. D T Boumpas1
  1. 1
    Internal Medicine, and Rheumatology, Clinical Immunology and Allergy, University of Crete School of Medicine, Heraklion, Greece
  2. 2
    Clinical Trials and Evidence-Based Medicine Unit, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
  3. 3
    Department of Nephrology and Transplantation Medicine, Laiko Hospital, Athens, Greece
  4. 4
    Cattedra di Reumatologia, Universita di Pisa, Pisa, Italy
  5. 5
    Department of Autoimmune Diseases, Hospital Clinic, Barcelona, Spain
  6. 6
    Institute of Rheumatology, Prague, Czech Republic
  7. 7
    Department of Rheumatology, Rikshospitalet, Oslo, Norway
  8. 8
    Rheumatology Department, Université catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium
  9. 9
    Department of Rheumatology Leiden University Medical Center, Leiden, The Netherlands
  10. 10
    Centre for Rheumatology, University College London Hospitals, London, UK
  11. 11
    Department of Clinical Immunology, University Medical Center Groningen, Groningen, The Netherlands
  12. 12
    Lupus Research Unit, The Rayne Institute, St Thomas’ Hospital, London, UK
  13. 13
    Service de Médecine Interne, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
  14. 14
    Rheumatolology, Clinic of Endocrinology, Diabetology and Rheumatology, Heinrich-Heine-University, Dusseldorf, Germany
  15. 15
    Department of Rheumatology, Medical University of Vienna, Austria
  16. 16
    Department of Rheumatology, University Hospital of Lund, Lund, Sweden
  17. 17
    Rheumatologia e Immunologia Clinica, Ospedale Civile di Brescia, Italy
  18. 18
    Rheumatology Unit, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden
  19. 19
    Centre for Immune Regulation, Division of Immunity and Infection, The University of Birmingham, Birmingham, UK
  1. D T Boumpas, Departments of Internal Medicine and Rheumatology, University of Crete School of Medicine, 71003, Heraklion, Greece; boumpasd{at}


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.

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  • Lay summary

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  • This is an abbreviated version of the recommendations. The full-text version is available online (

  • Dr Font died on 26 July 2006.

  • Competing interests: None declared.