University of Birmingham

A University of Birmingham academic has led the authorship of the UK’s first guideline on the care of adults with systemic lupus erythematosus (lupus).

Published today in Rheumatology, the guideline has been created by the British Society of Rheumatology, and covers diagnosis, assessment, monitoring and treatment of patients with mild, moderate and severe lupus.

Lead guideline author Caroline Gordon, a lupus expert and Professor of Rheumatology at the University of Birmingham, said: “Lupus can affect any part of the body and can be difficult to diagnose and treat. It is more common than many people realise, has a major impact on the health and activities of individuals with the disease and it is associated with a significant risk of dying prematurely - reducing average lifespan by about 25 years.

“This guideline is essential because it provides advice on how to diagnose the condition and then how to assess the disease and determine what type of treatment will be most suitable, whether people have common manifestations such as skin rashes and arthritis, or less common but potentially more serious problems such as kidney disease.”

It is aimed at rheumatologists and clinical nurse specialists in lupus, as well as nephrologists, immunologists, dermatologists, emergency medicine practitioners and GPs.

Professor Gordon adds: “As a result of this guideline I would expect that patients will experience measurable improvements in care.

“With earlier diagnosis and more appropriate treatment we should see more rapid resolution of symptoms, reduction in disease flares and improvements in the quality of life of patients, with less long-term complications of the disease and its treatment and improved survival rates.”

The guideline provides advice on how people should be monitored for evidence of improvement or deterioration, encourages the use of a variety of treatments to ensure less reliance on steroids to control symptoms and provides information on which drugs to use for people that do not respond to initial treatment plans.

Importantly, it also emphasises the need for people with the most serious and difficult to control forms of the disease to be referred to specialised lupus centres to access new therapies and multi-disciplinary teams.

It guides the care of patients with common symptoms such as skin rashes and arthritis as well as those with less common but potentially more serious problems like kidney disease.

For more information or to arrange interviews contact Emma McKinney, Communications Manager (Health Science), University of Birmingham: 0121 414 6681.

• Gordon et al (2017). ‘The British Society for Rheumatology guideline for the management of systemic lupus erythematosus in adults’. Rheumatology.
• Read the guideline here.
• The University of Birmingham is ranked amongst the world’s top 100 institutions. Its work brings people from across the world to Birmingham, including researchers, teachers and more than 5,000 international students from over 150 countries.
• British Society for Rheumatology exists to promote excellence in the treatment of people with arthritis and musculoskeletal conditions and to support those delivering it. It is the leading UK specialist medical society for rheumatology and musculoskeletal care professionals, representing the whole multi-disciplinary team: consultant rheumatologists, trainees, specialised nurses, physiotherapists, occupational therapists, psychologists and GPs with special interest in rheumatology. The society aims to improve standards of care in rheumatology and secure a high priority for rheumatology services.
• Systemic lupus erythematosus (SLE or lupus for short) is a multisystem, autoimmune disease which presents at any age, most commonly in women in their reproductive years although lupus is increasingly recognized after the age of 40, particularly in Europeans. Lupus affected nearly 1 in 1000 of the population in 2012 in the UK and is most frequently observed in people of African-Caribbean and South Asian descent. The disease is prone to relapses and remissions, resulting in considerable morbidity due to flares of disease activity and accumulated damage, with an increased risk of premature death, mostly due to infection or cardiovascular disease. About one third of lupus patients in the UK develop lupus nephritis.
• British Society for Rheumatology obtained National Institute for Heath and Care Excellence (NICE) accreditation in 2013, which recognises that the guidelines are robust, evidence-based and developed using critically evaluated high quality processes. The society has published a number of guidelines under NICE accreditation which can be viewed here.