GLADEL–PANLAR recommendations for musculoskeletal and cutaneous manifestations in patients with systemic lupus erythematosus
| Treatment recommendations | Quality of the evidence | Strength of recommendation |
| Musculoskeletal (MSK)Â manifestations | ||
| In adult patients with SLE and MSK manifestations | ||
| First line: Use SOC (GCs and AMs) alone over adding other IS. | Low | Weak |
| If disease remains active after SOC, add either MTX or LFN or belimumab or ABT over other IS. | Low to moderate | Weak |
| Cutaneous manifestations | ||
| In adult patients with different manifestations of cutaneous lupus | ||
| First line: Use SOC alone over adding other IS. | Low | Weak |
| If disease remains active after SOC, add MTX, AZA, MMF, CsA, CYC or belimumab over other IS. | Low to moderate | Weak |
ABT, abatacept; AM, antimalarials; AZA, azathioprine; CsA, cyclosporine A; CYC, cyclophosphamide; GC, glucocorticoid; GLADEL, Grupo Latino Americano de Estudio del Lupus; IS, immunosuppressant; LFN, leflunomide; MMF, mycophenolate mofetil; MTX, methotrexate; PANLAR, Pan-American League of Associations of Rheumatology; SLE, systemic lupus erythematosus; SOC, standard of care.