New strategy for glucocorticoid use in systemic lupus erythematosus
https://doi.org/10.47360/1995-4484-2025-421-431
Abstract
Glucocorticoids (GC) continue to be indispensable drugs for the treatment of systemic lupus erythematosus, since there are no other alternatives that can so quickly stop the activity of the disease. However, the accumulation of irreversible damage to organs (cataracts, osteoporosis, diabetes mellitus, etc.) significantly limits their use. This article examines the current views of leading rheumatologists on the treatment with GC in patients with SLE, namely three main principles: a) the use of pulse therapy with 6-methyl prednisone to induce remission not only in severe cases of the disease; b) limiting the initial doses of prednisone to <30 mg/day, with a rapid decrease to maintenance dose <5 mg/day; c) a personalized approach to the GC withdrawal strategy. Long-term hydroxychloroquine therapy and early implementation of immunosuppressive therapy will help achieve these goals.
About the Authors
E. A. Aseeva
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
Competing Interests:
Russian Federation
Elena A. Aseeva
115522, Moscow, Kashirskoye Highway, 34A
Competing Interests:
None
S. K. Soloviev
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
Competing Interests:
Russian Federation
Sergey K. Soloviev
115522, Moscow, Kashirskoye Highway, 34A
Competing Interests:
None
E. L. Nasonov
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
Competing Interests:
Russian Federation
Evgeny L. Nasonov
115522, Moscow, Kashirskoye Highway, 34A
Competing Interests:
None
References
1. Nasonov EL, Soloviev SK, Arshinov AV. Systemic lupus erythematosus: History and modernity. Nauchno-Prakticheskaya Revmatologia = Rheumatology Science and Practice. 2022;60(4):397-412 (In Russ.). doi: 10.47360/1995-4484-2022-397-412
2. Hench PS, Kendall EC, Slocumb CH, Polley HF. Adrenocortical hormone in arthritis: Preliminary report. Ann Rheum Dis. 1949;8:97-104. doi: 10.1136/ard.8.2.97
3. Dubois EL. Systemic lupus erythematosus; early cytologic diagnosis. Calif Med. 1954;80(3):154-158.
4. Posnick J. Systemic lupus erythematosus. The effect of corticotropin and adrenocorticoid therapy on survival rate. Calif Med. 1963;98(6):308-312.
5. Nasonova VA. Systemic lupus erythematosus. Moscow:Meditsina;1972 (In Russ.).
6. Ruiz-Arruza I, Ugarte A, Cabezas-Rodriguez I, Medina JA, Moran MA, Ruiz-Irastorza G. Glucocorticoids and irreversible damage in patients with systemic lupus erythematosus. Rheumatology (Oxford). 2014;53(8):1470-1476. doi: 10.1093/rheumatology/keu148
7. Ruiz-Irastorza G, Ugarte A, Ruiz-Arruza I, Khamashta M. Seventy years after Hench’s Nobel prize: Revisiting the use of glucocorticoids in systemic lupus erythematosus. Lupus. 2020;29(10):1155- 1167. doi: 10.1177/0961203320930099
8. Panopoulos S, Drosos GC, Konstantonis G, Sfikakis PP, Tektonidou MG. Generic and disease-adapted cardiovascular risk scores as predictors of atherosclerosis progression in SLE. Lupus Sci Med. 2023;10(1):e000864. doi: 10.1136/lupus-2022-000864
9. Ugarte-Gil MF, Mak A, Leong J, Dharmadhikari B, Kow NY, Reátegui-Sokolova C, et al. Impact of glucocorticoids on the incidence of lupus-related major organ damage: A systematic literature review and meta-regression analysis of longitudinal observational studies. Lupus Sci Med. 2021;8(1):e000590. doi: 10.1136/lupus-2021-000590
10. Danza A, Graña D, Soto E, Silveira G, Carlomagno A, Rebella M. Prednisone and long-term damage in systemic lupus erythematosus: Which is the threshold dose? A pilot study. Lupus. 2022;31(7):880-884. doi: 10.1177/09612033221093485
11. Buttgereit F, Wehling M, Burmester GR. A new hypothesis of modular glucocorticoid actions: Steroid treatment of rheumatic diseases revisited. Arthritis Rheum. 1998;41(5):761-767. doi: 10.1002/1529-0131(199805)41:5<761::AID-ART2>3.0.CO;2-M
12. Baschant U, Culemann S, Tuckermann J. Molecular determinants of glucocorticoid actions in inflammatory joint diseases. Mol Cell Endocrinol. 2013;380(1-2):108-118. doi: 10.1016/j.mce.2013.06.009
13. Nasonov EL. General characteristics and mechanisms of action of glucocorticoids. Russian Medical Journal. 1999;(8):4 (In Russ.).
14. Eiers AK, Vettorazzi S, Tuckermann JP. Journey through discovery of 75 years glucocorticoids: Evolution of our knowledge of glucocorticoid receptor mechanisms in rheumatic diseases. Ann Rheum Dis. 2024;83(12):1603-1613. doi: 10.1136/ard-2023-225371
15. Cain DW, Cidlowski JA. Immune regulation by glucocorticoids. Nat Rev Immunol. 2017;17(4):233-247. doi: 10.1038/nri.2017.1
16. Reichardt SD, Amouret A, Muzzi C, Vettorazzi S, Tuckermann JP, Lühder F, et al. The role of glucocorticoids in inflammatory diseases. Cells. 2021; 10(11): 2921. doi: 10.3390/cells10112921
17. Pofi R, Caratti G, Ray DW, Tomlinson JW. Treating the side effects of exogenous glucocorticoids; can we separate the good from the bad? Endocr Rev. 2023;44(6):975-1011. doi: 10.1210/endrev/bnad016
18. Panettieri RA, Schaafsma D, Amrani Y, Koziol-White C, Ostrom R, Tliba O. Non-genomic effects of glucocorticoids: An updated view. Trends Pharmacol Sci. 2019;40(1):38-49. doi: 10.1016/j.tips.2018.11.002
19. Hardy RS, Raza K, Cooper MS. Therapeutic glucocorticoids: Mechanisms of actions in rheumatic diseases. Nat Rev Rheumatol. 2020;16(3):133-144. doi: 10.1038/s41584-020-0371-y
20. Northcott M, Gearing LJ, Nim HT, Nataraja C, Hertzog P, Jones SA, et al. Glucocorticoid gene signatures in systemic lupus erythematosus and the effects of type I interferon: A cross-sectional and in-vitro study. Lancet Rheumatol. 2021;3(5):e357-e370. doi: 10.1016/S2665-9913(21)00006-0
21. Richter P, Macovei LA, Mihai IR, Cardoneanu A, Burlui MA, Rezus E. Cytokines in systemic lupus erythematosus – focus on TNF-α and IL-17. Int J Mol Sci. 2023;24(19):14413. doi: 10.3390/ijms241914413
22. Idborg H, Oke V. Cytokines as biomarkers in systemic lupus erythematosus: Value for diagnosis and drug therapy. Int J Mol Sci. 2021;22(21):11327. doi: 10.3390/ijms222111327
23. Aringer M. Inflammatory markers in systemic lupus erythematosus. J Autoimmun. 2020;110:102374. doi: 10.1016/j.jaut.2019.102374
24. Ding H, Shen Y, Hong SM, Xiang C, Shen N. Biomarkers for systemic lupus erythematosus – a focus on organ damage. Expert Rev Clin Immunol. 2024;20(1):39-58. doi: 10.1080/1744666X.2023.2260098
25. Franco LM, Gadkari M, Howe KN, Sun J, Kardava L, Kumar P, et al. Immune regulation by glucocorticoids can be linked to cell type-dependent transcriptional responses. J Exp Med. 2019;216(2):384-406. doi: 10.1084/jem.20180595
26. Porta S, Danza A, Arias Saavedra M, Carlomagno A, Goizueta MC, Vivero F, et al. Glucocorticoids in systemic lupus erythematosus. Ten questions and some issues. J Clin Med. 2020;9(9):2709. doi: 10.3390/jcm9092709
27. Danza A, Borgia I, Narváez JI, Baccelli A, Amigo C, Rebella M, et al. Intravenous pulses of methylprednisolone to treat flares of immune-mediated diseases: How much, how long? Lupus. 2018;27(7):1177-1184. doi: 10.1177/0961203318768888
28. Ruiz-Arruza I, Lozano J, Cabezas-Rodriguez I, Medina JA, Ugarte A, Erdozain JG, et al. Restrictive use of oral glucocorticoids in systemic lupus erythematosus and prevention of damage without worsening long-term disease control: An observational study. Arthritis Care Res (Hoboken). 2018;70(4):582-591. doi: 10.1002/acr.23322
29. Ruiz-Irastorza G, Ruiz-Estevez B, Lazaro E, Ruiz-Arruza I, Duffau P, Martin-Cascon M, et al. Prolonged remission in SLE is possible by using reduced doses of prednisone: An observational study from the Lupus-Cruces and Lupus-Bordeaux inception cohorts. Autoimmun Rev. 2019;18(9):102359. doi: 10.1016/j.autrev.2019.102359
30. Condon MB, Ashby D, Pepper RJ, Cook HT, Levy JB, Griffith M, et al. Prospective observational single-centre cohort study to evaluate the effectiveness of treating lupus nephritis with rituximab and mycophenolate mofetil but no oral steroids. Ann Rheum Dis. 2013;72(8):1280-1286. doi: 10.1136/annrheumdis-2012-202844
31. Zeher M, Doria A, Lan J, Aroca G, Jayne D, Boletis I, et al. Efficacy and safety of enteric-coated mycophenolate sodium in combination with two glucocorticoid regimens for the treatment of active lupus nephritis. Lupus. 2011;20(14):1484-1493. doi: 10.1177/0961203311418269
32. Rovin BH, Solomons N, Pendergraft WF 3rd, Dooley MA, Tumlin J, Romero-Diaz J, et al; AURA-LV Study Group. A randomized, controlled double-blind study comparing the efficacy and safety of dose-ranging voclosporin with placebo in achieving remission in patients with active lupus nephritis. Kidney Int. 2019;95(1):219-231. doi: 10.1016/j.kint.2018.08.025
33. Chambers SA, Allen E, Rahman A, Isenberg D. Damage and mortality in a group of British patients with systemic lupus erythematosus followed up for over 10 years. Rheumatology (Oxford). 2009;48(6):673-675. doi: 10.1093/rheumatology/kep062
34. Ruiz-Irastorza G, Danza A, Perales I, Villar I, Garcia M, Delgado S, et al. Prednisone in lupus nephritis: How much is enough? Autoimmun Rev. 2014;13(2):206-214. doi: 10.1016/j.autrev.2013.10.013
35. Zonana-Nacach A, Barr SG, Magder LS, Petri M. Damage in systemic lupus erythematosus and its association with corticosteroids. Arthritis Rheum. 2000;43(8):1801-1808. doi: 10.1002/1529-0131(200008)43:8<1801::AIDANR16>3.0.CO;2-O
36. Al Sawah S, Zhang X, Zhu B, Magder LS, Foster SA, Iikuni N, et al. Effect of corticosteroid use by dose on the risk of developing organ damage over time in systemic lupus erythematosus – the Hopkins Lupus Cohort. Lupus Sci Med. 2015;2(1):e000066. doi: 10.1136/lupus-2014-000066
37. Enríquez-Merayo E, Cuadrado MJ. Steroids in lupus: Enemies or allies. J Clin Med. 2023;12(11):3639. doi: 10.3390/jcm12113639
38. Durcan L, O’Dwyer T, Petri M. Management strategies and future directions for systemic lupus erythematosus in adults. Lancet. 2019;393(10188):2332-2343. doi: 10.1016/S0140-6736(19)30237-5
39. Aseeva EA, Solovyev SK, Pletnev EA, Koilubaeva GM, Issayeva BG, Nasonov EL. Treat-to-target SLE strategy in 10 years: Discussion of current limitations and available options for implementation in real-world clinical practice. Nauchno-Prakticheskaya Revmatologia = Rheumatology Science and Practice. 2025;63(3):229-238 (In Russ.). doi: 10.47360/1995-4484-2025-229-238
40. Fanouriakis A, Kostopoulou M, Alunno A, Aringer M, Bajema I, Boletis JN, et al. 2019 update of the EULAR recommendations for the management of systemic lupus erythematosus. Ann Rheum Dis. 2019;78(6):736-745. doi: 10.1136/annrheumdis-2019-215089
41. Pons-Estel BA, Bonfa E, Soriano ER, Cardiel MH, Izcovich A, Popoff F, et al.; Grupo Latino Americano de Estudio del Lupus (GLADEL) and Pan-American League of Associations of Rheumatology (PANLAR). First Latin American clinical practice guidelines for the treatment of systemic lupus erythematosus: Latin American Group for the Study of Lupus (GLADEL, Grupo Latino Americano de Estudio del Lupus)-Pan-American League of Associations of Rheumatology (PANLAR). Ann Rheum Dis. 2018;77(11):1549-1557. doi: 10.1136/annrheumdis-2018-213512
42. Fanouriakis A, Kostopoulou M, Cheema K, Anders HJ, Aringer M, Bajema I, et al. 2019 update of the joint European League Against Rheumatism and European Renal Association-European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for the management of lupus nephritis. Ann Rheum Dis. 2020;79(6):713-723. doi: 10.1136/annrheumdis-2020-216924
43. Fanouriakis A, Kostopoulou M, Andersen J, Aringer M, Arnaud L, Bae SC, et al. EULAR recommendations for the management of systemic lupus erythematosus: 2023 update. Ann Rheum Dis. 2024;83(1):15-29. doi: 10.1136/ard-2023-224762
44. Kidney Disease: Improving Global Outcomes (KDIGO) lupus nephritis work group. KDIGO 2024 Clinical Practice Guideline for the management of LUPUS NEPHRITIS. Kidney Int. 2024;105(1S):S1-S69. doi: 10.1016/j.kint.2023.09.002
45. Aseeva EA, Soloviev SK, Pletnev EA, Dacina AV. 2024 ACR guidelines on screening, treatment, and management of patients with lupus nephritis. Modern Rheumatology Journal. 2025;19(3):27-32 (In Russ.). doi: 10.14412/1996-7012-2025-3-27-32
46. Sammaritano LR, Askanase A, Bermas BL, Dall’Era M, DuarteGarcía A, Hiraki LT, et al. 2024 American College of Rheumatology (ACR) guideline for the screening, treatment, and management of lupus nephritis. Arthritis Care Res (Hoboken). 2025;77(9):1045-1065. doi: 10.1002/acr.25528
47. Figueroa-Parra G, Cuéllar-Gutiérrez MC, González-Treviño M, Sanchez-Rodriguez A, Flores-Gouyonnet J, Meade-Aguilar JA, et al. Impact of glucocorticoid dose on complete response, serious infections, and mortality during the initial therapy of lupus nephritis: A systematic review and meta-analysis of the control arms of randomized controlled trials. Arthritis Rheumatol. 2024;76(9):1408-1418. doi: 10.1002/art.42920
48. Fanouriakis A, Bertsias G. Changing paradigms in the treatment of systemic lupus erythematosus. Lupus Sci Med. 2019;6(1):e000310. doi: 10.1136/lupus-2018-000310
49. Paredes-Ruiz D, Ruiz-Irastorza G, Amoura Z. Systemic lupus erythematosus and glucocorticoids: A never-ending story? Best Pract Res Clin Rheumatol. 2023;37(4):101873. doi: 10.1016/j.berh.2023.101873
50. Lightstone L, Doria A, Wilson H, Ward FL, Larosa M, Bargman JM. Can we manage lupus nephritis without chronic corticosteroids administration? Autoimmun Rev. 2018;17(1):4-10. doi: 10.1016/j.autrev.2017.11.002
51. Ngamjanyaporn P, McCarthy EM, Sergeant JC, Reynolds J, Skeoch S, Parker B, et al. Clinicians approaches to management of background treatment in patients with SLE in clinical remission: Results of an international observational survey. Lupus Sci Med. 2017;4(1):e000173. doi: 10.1136/lupus-2016-000173
52. Huang S, Jia Y, Zhang Y, Chen H, Deng C, Fei Y. Effects of glucocorticoid withdrawal on relapse risk in systemic lupus erythematosus: A systematic review and meta-analysis. iScience. 2025;28(7):112875. doi: 10.1016/j.isci.2025.112875
53. Ji L, Xie W, Fasano S, Zhang Z. Risk factors of flare in patients with systemic lupus erythematosus after glucocorticoids with drawal. A systematic review and meta-analysis. Lupus Sci Med. 2022;9(1):e000603. doi: 10.1136/lupus-2021-000603
54. Fei Y, Zhao L, Wu L, Zuo X, Li R, Cheng J, et al; PRESS study team. Evaluation and prediction of relapse risk in stable systemic lupus erythematosus patients after glucocorticoid withdrawal (PRESS): An open-label, multicentre, non-inferiority, randomised controlled study in China. Ann Rheum Dis. 2025;84(2):274-283. doi: 10.1136/ard-2024-225826
55. Floris A, Chessa E, Sebastiani GD, Prevete I, Iannone F, Coladonato L, et al.; study group on Early SLE of the Italian Society of Rheumatology (SIR). Glucocorticoid tapering and associated outcome in patients with newly diagnosed systemic lupus erythematosus: The real-world GULP prospective observational study. RMD Open. 2022;8(2):e002701. doi: 10.1136/rmdopen-2022-002701
56. Tanaka Y. Revolutionary changes in the management of lupus nephritis: Towards de-glucocorticoid or no-glucocorticoid. Drugs. 2025;85(4):447-455. doi: 10.1007/s40265-025-02156-2
57. Solovyev SK, Aseeva EA, Nasonov EL, Lila AM, Koilubaeva GM. Possibilities and prospects for glucocorticoid withdrawal in systemic lupus erythematosus. Modern Rheumatology Journal. 2020;14(1):6-11 (In Russ.). doi: 10.14412/1996-7012-2020-1-6-11
58. Soloviev SK, Mesnyankina AA, Nikishina NY, Aseeva EA, Lila AM. Treatment of patients with systemic lupus erythematosus without glucocorticoids – myth or reality? Modern Rheumatology Journal. 2022;16(1):77-83 (In Russ.). doi: 10.14412/1996-7012-2022-1-77-83
59. Nasonov EL, Popkova TV, Lila AM. Belimumab in the treatment of systemic lupus erythematosus: 20 years of basic research, 10 years of clinical practice. Nauchno-Prakticheskaya Revmatologia = Rheumatology Science and Practice. 2021;59(4):367-383 (In Russ.). doi: 10.47360/1995-4484-2021-367-383
60. Nasonov EL, Avdeeva AS, Popkova TV. New possibilities of pharmacotherapy for systemic lupus erythematosus: Prospects for the use of anifrolumab (monoclonal antibodies to type I interferon receptor). Nauchno-Prakticheskaya Revmatologia = Rheumatology Science and Practice. 2021;59(5):537-546 (In Russ.). doi: 10.47360/1995-4484-2021-537-546
61. Nasonov EL. Prospects for anti-B-cell therapy in rheumatology. Nauchno-Prakticheskaya Revmatologia = Rheumatology Science and Practice. 2018;56(5):539-548 (In Russ.). doi: 10.14412/1995-4484-2018-539-548
62. Mo S, Li Y, He J, Lin L. Progress of rituximab in the treatment of systemic lupus erythematosus and lupus nephritis. Front Med (Lausanne). 2024;11:1472019. doi: 10.3389/fmed.2024.1472019
63. Marinho A, Delgado Alves J, Fortuna J, Faria R, Almeida I, Alves G, et al. Biological therapy in systemic lupus erythematosus, antiphospholipid syndrome, and Sjögren’s syndrome: Evidenceand practice-based guidance. Front Immunol. 2023;14:1117699. doi: 10.3389/fimmu.2023.1117699
64. Ezeonyeji AN, Isenberg DA. Early treatment with rituximab in newly diagnosed systemic lupus erythematosus patients: A steroid-sparing regimen. Rheumatology (Oxford). 2012;51(3):476-481. doi: 10.1093/rheumatology/ker337
65. Tsanyan ME, Soloviev SK, Torgashina AV, Aleksandrova EN, Radenska-Lopovok SG, Nikolaeva EV, et al. Rituximab treatment efficacy in patients with systemic lupus erythematosus refractory to standard therapy in the long-term follow-up. Nauchno-Prakticheskaya Revmatologia = Rheumatology Science and Practice. 2014;52(2):159-168 (In Russ.). doi: 10.14412/1995-4484-2014-159-168
66. Navarra SV, Guzmán RM, Gallacher AE, Hall S, Levy RA, Jimenez RE, et al.; BLISS-52 Study Group. Efficacy and safety of belimumab in patients with active systemic lupus erythematosus: A randomised, placebo-controlled, phase 3 trial. Lancet. 2011;377(9767):721-731. doi: 10.1016/S0140-6736(10)61354-2
67. Furie R, Petri M, Zamani O, Cervera R, Wallace DJ, Tegzová D, et al.; BLISS-76 Study Group. A phase III, randomized, placebocontrolled study of belimumab, a monoclonal antibody that inhibits B lymphocyte stimulator, in patients with systemic lupus erythematosus. Arthritis Rheum. 2011;63(12):3918-3930. doi: 10.1002/ art.30613
68. Stohl W, Schwarting A, Okada M, Scheinberg M, Doria A, Hammer AE, et al. Efficacy and safety of subcutaneous Belimumab in systemic lupus erythematosus: A fifty-two-week randomized, double-blind, placebo-controlled study. Arthritis Rheumatol. 2017;69(5):1016-1027. doi: 10.1002/art.40049
69. Aseeva EA, Soloviev SK, Mesnyankina AA, Reshetnyak TM, Lopatina NE, Glukhova SI, et al. Results of an observational prospective study of the efficacy and safety of Belimumab (Benlysta®) in systemic lupus erythematosus in real clinical practice. Nauchno-Prakticheskaya Revmatologia = Rheumatology Science and Practice. 2016;54(1):31-37 (In Russ.). doi: 10.14412/1995-4484-2016-31-37
70. Aseeva EA, Soloviev SK, Mesnyankina AA, Tsanyan ME, Nasonov EL. Experience with Belimumab in patients with systemic lupus erythematosus. Nauchno-Prakticheskaya Revmatologia = Rheumatology Science and Practice. 2015;53(3):329-335 (In Russ.). doi: 10.14412/1995-4484-2015-329-335
71. Furie R, Morand EF, Askanase AD, Vital EM, Merrill JT, Kalyani RN, et al. Anifrolumab reduces flare rates in patients with moderate to severe systemic lupus erythematosus. Lupus. 2021;30(8):1254-1263. doi: 10.1177/09612033211014267
72. Merrill JT, Werth V, Furie R, Morand E, Kahlenberg J, Abreu G, et al. Anifrolumab effects on rash and arthritis in patients with SLE and impact of interferon signal in pooled data from phase 3 trials. Ann Rheum Dis. 2021;80:75-76. doi: 10.1136/annrheumdis-2021-eular.1471
73. Kalunian KC, Furie R, Morand EF, Bruce IN, Manzi S, Tanaka Y, et al. A randomized, placebo-controlled phase III extension trial of the long-term safety and tolerability of anifrolumab in active systemic lupus erythematosus. Arthritis Rheumatol. 2023;75(2):253-265. doi: 10.1002/art.42392
74. Reshetnyak TM, Aseeva EA, Shumilova AA, Nikishina NY, Glukhova SI, Shkireeva SY, et al. Efficacy and safety of the type I interferon receptor inhibitor anifrolumab in patients with systemic lupus erythematosus (results of a 6-month study). Modern Rheumatology Journal. 2024;18(2):16- 24 (In Russ.). doi: 10.14412/1996-7012-2024-2-16-24
75. Guiducci C, Gong M, Xu Z, Gill M, Chaussabel D, Meeker T, et al. TLR recognition of self nucleic acids hampers glucocorticoid activity in lupus. Nature. 2010;465(7300):937-941. doi: 10.1038/nature09102
76. Lepelletier Y, Zollinger R, Ghirelli C, Raynaud F, Hadj-Slimane R, Cappuccio A, et al. Toll-like receptor control of glucocorticoid-induced apoptosis in human plasmacytoid predendritic cells (pDCs). Blood. 2010;116(18):3389-3397. doi: 10.1182/blood-2010-05-282913
77. Felger JC, Haroon E, Woolwine BJ, Raison CL, Miller AH. Interferon-alpha-induced inflammation is associated with reduced glucocorticoid negative feedback sensitivity and depression in patients with hepatitis C virus. Physiol Behav. 2016;166:14-21. doi: 10.1016/j.physbeh.2015.12.013
78. Martin-Iglesias D, Paredes-Ruiz D, Ruiz-Irastorza G. Use of glucocorticoids in SLE: A clinical approach. Mediterr J Rheumatol. 2024;35(Suppl 2):342-353. doi: 10.31138/mjr.230124.uos
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Aseeva E.A., Soloviev S.K., Nasonov E.L. New strategy for glucocorticoid use in systemic lupus erythematosus. Rheumatology Science and Practice. 2025;63(5):421-431. (In Russ.) https://doi.org/10.47360/1995-4484-2025-421-431
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