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SAN FRANCISCO—Rheumatologists have to look no further than the American College of Rheumatology guidelines to know that the options for patients with lupus nephritis are sometimes not very appealing.
The first-line choices are either mycophenolate mofetil (MMF) plus glucocorticoids or cyclophosphamide (CYC), also with glucocorticoids—and all of their attendant side effects. The problem: evidence, said Joan Merrill, MD, chair of the Clinical Pharmacology Research Program at the Oklahoma Medical Research Foundation. Her work focuses on lupus and she was one of the contributors to the guidelines. The work was presented to attendees of the 2015 ACR/ARHP Annual Meeting.
“Our task was to make recommendations based on the best evidence,” Dr. Merrill said. “And the problem here is that we don’t have sufficient evidence yet to do what our technology has now made possible, which is to approach this disease in a much more rational way.”