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Review
. 2025;21(1):70-96.
doi: 10.2174/0115733971275638240429063041.

Saudi National Clinical Practice Guidelines for Management of Adult Systemic Lupus Erythematosus

Ahmed H Al-Jedai  1   2 , Hajer Y Almudaiheem  1 , Ibrahim A Al-Homood  3   4 , Ibrahim Almaghlouth  5   6 , Sami M Bahlas  7 , Abdulaziz Mohammed Alolaiwi  1   8 , Mohammad Fatani  9 , Maysa Tariq Eshmawi  10   11 , Bedor A AlOmari  12 , Khalidah Ahmed Alenzi  13 , Rayan G Albarakati  14 , Nayef Al Ghanim  8
Affiliations
Review

Saudi National Clinical Practice Guidelines for Management of Adult Systemic Lupus Erythematosus

Ahmed H Al-Jedai et al. Curr Rheumatol Rev. 2025.

Abstract

Objective: To provide evidence-based clinical practice recommendations for managing Systemic Lupus Erythematosus (SLE) in Saudi Arabia.

Methods: This EULAR-adapted national guideline in which a multidisciplinary task force utilized the modified Delphi method to develop 31 clinical key questions. A systematic literature review was conducted to update the evidence since the EULAR publication. After reaching a consensus agreement, two rounds of voting and group discussion were conducted to generate consolidated recommendations/ statements.

Results: A significant number of patients in Saudi Arabia experience delays in accessing rheumatologists, highlighting the significance of timely referral to SLE specialists or rheumatologists to ensure accurate diagnosis and prompt treatment. The primary goal of Glucocorticoid (GC) therapy in SLE patients is to establish disease control with a minimum dose and duration. Steroid-sparing agent utilization facilitates steroid-sparing goals. Hydroxychloroquine is recommended for all SLE patients, though physicians must carefully monitor toxicity and prioritize regular medication adherence assessment. SLE management during pregnancy starts from preconception time by assessing disease activity, major organ involvement, hypercoagulability status, and concomitant diseases that may negatively impact maternal and fetal outcomes. Multidisciplinary care with close monitoring may optimize both maternal and fetal outcomes. For patients with antiphospholipid antibodies, low-dose aspirin prophylaxis is recommended. Also, Long-term anticoagulant medications are fundamental to prevent secondary antiphospholipid syndrome due to high thrombosis recurrence.

Conclusion: This Saudi National Clinical Practice guidelines for SLE management provide evidence- based recommendations and guidance for healthcare providers in Saudi Arabia who are managing patients with SLE. These guidelines will help to standardize healthcare service, improve provider education, and perhaps lead to better treatment outcomes for SLE patients.

Keywords: Saudi Arabia; Steroid-sparing agent; Systemic lupus erythematosus; disease activity; glucocorticoid.; guidelines.

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Conflict of interest statement

All the authors whose names are listed above certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria, educational grants, participation in speakers’ bureaus, membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Figures

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Fig. (1)
Methodology flowchart.
Fig. (2)
Fig. (2)
PRISMA flow chart for systematic literature review.
See this image and copyright information in PMC

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