GLADEL–PANLAR recommendations for adult and childhood-onset lupus nephritis
| Lupus nephritis | ||
| Treatment recommendations | Quality of the evidence | Strength of recommendation |
| Induction therapy for adult patients with lupus-related nephritis | ||
| Use SOC (GCs and AMs) plus another IS agent (CYC, MMF or TAC) over GCs alone. | Moderate | Strong |
| Maintenance therapy for adult patients with lupus-related nephritis | ||
| Use MMF or AZA over CYC. | Low | Strong* |
| Induction therapy for childhood patient with lupus-related nephritis | ||
| Use high-dose GCs (prednisone 1–2 mg/kg/day, maximum 60 mg/day) plus another IS agent (MMF or CYC) over high-dose GCs alone. | Low | Weak |
| Maintenance therapy for childhood patient with lupus-related nephritis | ||
| Use MMF or AZA over CYC. | Low | Weak |
*Strong recommendation supported on high certainty in less adverse events with MMF or AZA than with CYC.
AM, antimalarials; AZA, azathioprine; CYC, cyclophosphamide; GC, glucocorticoid; GLADEL, Grupo Latino Americano de Estudio del Lupus; IS, immunosuppressant; MMF, mycophenolate mofetil; PANLAR, Pan-American League of Associations of Rheumatology; SOC, standard of care; TAC, tacrolimus.