Systemic lupus erythematosus (SLE) is characterized by great clinical heterogeneity. The objectives of its management are to make a timely diagnosis and to initiate treatment as promptly as possible so organ damage can be avoided while at the same time exposure to potentially toxic drugs is minimized so that its overall course and outcome improve. In reviewing the current literature, it became quite clear that there are specific topics in which controversies do exist. These include how to treat patients with incomplete lupus erythematosus, the real possibility of abandoning altogether the use of oral glucocorticoids, and the pros and cons of the use of cyclophosphamide and mycophenolate mofetil for the induction treatment of lupus nephritis. Herein we discuss different points of view regarding these still unresolved issues; these comments represent a debate that took place during the PANLAR Virtual Congress (Pan American League of Associations for Rheumatology) and that was organized by the PANLAR Lupus study group, GLADEL (Grupo Latino Americano De Estudio del Lupus) on September 19, 2020.
Bibliographical noteFunding Information:
M.F.U.-G. has received research grants from Pfizer and Janssen. J.A.G.-P. has received less than US $10,000 in speaking fees from GSK, Janssen, Lilly Pfizer, and Roche. L.A. has received consulting/research grants from Alexion, Amgen, Astra-Zeneca, BMS, Boehringer-Ingelheim, GSK, Grifols, Janssen-Cilag, LFB, Lilly, Medac, Novartis, Pfizer, Roche-Chugaï, and UCB. M.H.C. is principal investigator of or advisor or speaker for Abbvie, Amgen, Astra Zéneca, Eli Lilly, Gilead, Glaxo Smith Kline, Janssen, Pfizer, and Roche. The other authors declare no conflict of interest.
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- incomplete lupus
- lupus nephritis
- systemic lupus erythematosus