The British Society for Rheumatology guideline for the management of systemic lupus erythematosus in adults: executive summary

Need for the guideline
SLE (or lupus) is a complex, multi-system autoimmune disease that affects nearly 1 in 1000 people in the UK . Despite improvement in survival over the last
40 years, lupus patients still die on average 25 years earlier than the mean for women and men in the UK.
General recommendations for the management of lupus have not been published since 2008, although European and USA guidelines for LN management were published in 2012. As the disease causes significant morbidity and mortality, and can be associated with the rapid accumulation of damage if not promptly diagnosed, regularly monitored and appropriately treated, an up-to-date guideline, consistent with current National Health Service (NHS) practice, is warranted to help improve the outcome of this disease.

Objectives of the guideline
To provide comprehensive recommendations, covering the diagnosis,
assessment, monitoring and treatment of mild, moderate and severe active lupus disease based on a literature review (to June 2015) for non-renal lupus, supplemented as necessary by UK expert opinion and consensus agreement, and that do not imply a legal obligation. We also provide a summary of and our
strength of agreement (SOA) with the EULAR and European Renal Association European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for LN in the full guideline.

Target audience
The guidelines have been developed by a multidisciplinary group established by the British Society for Rheumatology (BSR) and consisting of academic and
NHS consultants in rheumatology and nephrology, rheumatology trainees, a general practitioner, a clinical nurse specialist, a patient representative and a lay
member. The target audience for the guideline includes rheumatologists and other clinicians who care for lupus patients, such as nephrologists, immunologists, dermatologists, emergency medicine practitioners, general
practitioners, trainees, clinical nurse specialists and other allied health professionals.

Areas that the guideline does not cover
This guideline does not cover the evidence for topical or systemic therapy for isolated cutaneous lupus, or paediatric lupus. Detailed dosing regimens are beyond the scope of this document. The management of the complications of lupus (including chronic fatigue, thrombosis, cardiovascular risk, osteoporosis, infection and cancer risk) are not discussed in detail and should be managed
as for patients with similar risk factors according to relevant national and international guidelines.