<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2393-6797</journal-id>
<journal-title><![CDATA[Revista Uruguaya de Medicina Interna ]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Urug. Med. Int.]]></abbrev-journal-title>
<issn>2393-6797</issn>
<publisher>
<publisher-name><![CDATA[Sociedad de Medicina Interna del Uruguay]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2393-67972021000100014</article-id>
<article-id pub-id-type="doi">10.26445/06.01.2</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Relación entre el uso de glucocorticoides y el daño crónico en Lupus Eritematoso Sistémico: una asociación precoz y nociva. Estudio exploratorio.]]></article-title>
<article-title xml:lang="en"><![CDATA[Glucocorticoids related damage in Systemic Lupus Erythematosus: an early and harmful association. An exploratory analysis.]]></article-title>
<article-title xml:lang="pt"><![CDATA[Relação entre o uso de glicocorticóides e dano crônico no Lupus Eritematoso Sistêmico: uma associação precoce e prejudicial. Estudo exploratório.]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Danza]]></surname>
<given-names><![CDATA[Alvaro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Narváez]]></surname>
<given-names><![CDATA[Jorge]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Graña]]></surname>
<given-names><![CDATA[Diego]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pérez]]></surname>
<given-names><![CDATA[Leticia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Viera]]></surname>
<given-names><![CDATA[Alexander]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Baccelli]]></surname>
<given-names><![CDATA[Augusto]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Borgia]]></surname>
<given-names><![CDATA[Ignacio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Roca]]></surname>
<given-names><![CDATA[Federico]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de la República Facultad de Medicina Clínica Médica 2.]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>03</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>03</month>
<year>2021</year>
</pub-date>
<volume>6</volume>
<numero>1</numero>
<fpage>14</fpage>
<lpage>23</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_arttext&amp;pid=S2393-67972021000100014&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_abstract&amp;pid=S2393-67972021000100014&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_pdf&amp;pid=S2393-67972021000100014&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Introducción:  La actividad inflamatoria persistente el Lupus Eritematoso Sistémico provoca daño permanente. El daño permanente puede ser atribuido a la enfermedad y/o al tratamiento, en particular los glucocorticoides. El objetivo de este trabajo fue conocer la relación entre el daño crónico y la exposición a glucocorticoides.  Material y métodos: Se realizó un muestreo no probabilístico de pacientes con lupus eritematoso sistémico. Se analizaron variables demográficas, niveles de actividad, dosis prednisona iniciales y acumuladas y niveles de daño medidos por &#8220;SLICC Damage Index &#8221; en diferentes periodos de la enfermedad. El daño fue clasificado en &#8220;relacionado&#8221; y &#8220;no relacionado&#8221; con el uso de glucocorticoides.  Resultados:  Se analizaron 30 pacientes, todos de sexo femenino. La media de seguimiento fueron 155 (DE 127) meses. Al final del seguimiento 13/30 (43,3%) pacientes presentaron daño orgánico. Los pacientes que presentaron daño orgánico &#8220;relacionado&#8221; con glucocorticoides al final del seguimiento presentaron dosis de inicio de prednisona significativamente mayores que los que no presentaron daño 53,3 (DE 10,3) mg/día vs. 28, 3 (DE 24) mg/día, p&lt;0,05. Dosis de inicio mayores a 30 mg/día se relacionaron con el daño al final del seguimiento, independientemente de los niveles de actividad considerados, OR 2,05 (IC 95% 1,5 - 4,0). Las dosis acumuladas de prednisona mayores a 3000 mg en el primer año se asociaron con daño relacionado con glucocorticoides al final del seguimiento (p &lt; 0,05).  Conclusiones:  Existe una acumulación de daño a lo largo del tiempo relacionado con los glucocorticoides. Esta relación es precoz, esto es, las dosis de inicio pueden relacionarse con la acumulación de daño a largo plazo, particularmente considerando los dominios relacionados con glucocorticoides, independientemente del nivel de actividad considerado.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Introduction:  Persistent activity causes irreversible organ damage in Systemic Lupus Erythematosus (SLE). Permanent damage can be attributed to the disease and to the treatment, particularly glucocorticoids. We aimed to know the relationship between the presence of organ damage and the exposure to glucocorticoids (GCC).  Methodology:  A non-probabilistic retrospective study of patients with SLE was performed. Demographic variables, activity levels, initial, accumulated prednisone dose and damage measured by "SLICC Damage Index (SDI)" at various stages from the diagnosis of the disease, were analyzed. Damage was classified in related and not related to GCC.  Results:  Thirty patients were analyzed, all women. The mean follow-up was 155 (SD: 127) months. At the end of follow-up 13/30 (43.3%) patients presented organ damage. Patients who had GCC-related damage at the end of follow-up had a significantly higher mean starting dose of prednisone, 53.3 (SD: 10.3) mg/d vs. 28.3 (SD: 24) mg/d, p &lt;0.05. The effect on damage was observed with prednisone starting dose greater than 30 mg/d, regardless of the level of activity at the onset of the disease, OR 2.05 (CI 95% 1.5 - 4.0). Cumulative doses of prednisone at one year greater than 3000 mg, were related to GCC-related damage at the end of the follow-up (p &lt; 0.05).  Conclusions: There is an accrual of damage over time associated to glucocorticoids exposure. It is highlighted that the relationship is early, that is, the starting dose will probably signify the accumulation of damage, especially in glucocorticoid-related domains, regardless of activity levels.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo:  Introdução:  A atividade inflamatória persistente do Lúpus Eritematoso Sistêmico (LES) causa danos permanentes. Danos permanentes podem ser atribuídos a doenças e / ou tratamento, particularmente glicocorticóides. O objetivo deste trabalho foi conhecer a relação entre dano crônico e exposição a glicocorticóides.  Material e métodos:  Foi realizada uma amostragem não probabilística de pacientes com LES. Variáveis demográficas, níveis de atividade, doses iniciais e acumuladas de prednisona e níveis de dano medidos pelo &#8220;SLICC Damage Index (SDI)&#8221; foram analisados em diferentes períodos da doença. O dano foi classificado como "relacionado" e "não relacionado" ao uso de glicocorticóides.  Resultados:  30 pacientes, todos do sexo feminino, foram analisados. O seguimento médio foi de 155 (DP 127) meses. Ao final do seguimento 13/30 (43,3%) pacientes apresentavam lesão orgânica. Os pacientes que apresentaram lesão orgânica &#8220;relacionada&#8221; aos glicocorticoides ao final do seguimento tiveram doses iniciais de prednisona significativamente maiores do que aqueles que não apresentaram lesão: 53,3 (DP 10,3) mg / dia vs. 28,3 (SD 24) mg / dia, p &lt;0,05. Doses iniciais maiores que 30 mg / dia foram relacionadas a danos ao final do seguimento, independentemente dos níveis de atividade considerados, OR 2,05 (IC 95% 1,5 - 4,0). Doses cumulativas de prednisona maiores que 3000 mg no primeiro ano foram associadas a danos relacionados aos glicocorticoides no final do acompanhamento (p &lt;0,05).  Conclusões:  Há um acúmulo de danos ao longo do tempo relacionados aos glicocorticóides. Essa relação é precoce, ou seja, as doses iniciais podem estar relacionadas ao acúmulo de danos em longo prazo, principalmente considerando os domínios relacionados aos glicocorticóides, independentemente do nível de atividade considerado.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Glucocorticoides]]></kwd>
<kwd lng="es"><![CDATA[Lupus eritematoso sistémico]]></kwd>
<kwd lng="es"><![CDATA[Efectos colaterales y reacciones adversas relacionadas con medicamentos]]></kwd>
<kwd lng="en"><![CDATA[Systemic lupus erythematosus]]></kwd>
<kwd lng="en"><![CDATA[Glucocorticoids]]></kwd>
<kwd lng="en"><![CDATA[Treatment safety]]></kwd>
<kwd lng="en"><![CDATA[Chronic damage]]></kwd>
<kwd lng="pt"><![CDATA[Glicocorticóides]]></kwd>
<kwd lng="pt"><![CDATA[Lúpus eritematoso sistêmico]]></kwd>
<kwd lng="pt"><![CDATA[Efeitos colaterais e reações adversas relacionadas a medicamentos]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<collab>D ´Cruz D.Khamashta M.Hughes GRV</collab>
<article-title xml:lang=""><![CDATA[Systemic lupus erythematosus]]></article-title>
<source><![CDATA[Lancet]]></source>
<year>2007</year>
<volume>369</volume>
<page-range>587-96</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jiménez]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Cervera]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Font]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Ingelmo]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The epidemiology of systemic lupus erythematosus]]></article-title>
<source><![CDATA[Clin Rev Allergy Immunol]]></source>
<year>2003</year>
<volume>25</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>3-12</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pons-Estel]]></surname>
<given-names><![CDATA[BA]]></given-names>
</name>
<name>
<surname><![CDATA[Catoggio]]></surname>
<given-names><![CDATA[LJ]]></given-names>
</name>
<name>
<surname><![CDATA[Cardiel]]></surname>
<given-names><![CDATA[MH]]></given-names>
</name>
<name>
<surname><![CDATA[Soriano]]></surname>
<given-names><![CDATA[ER]]></given-names>
</name>
<name>
<surname><![CDATA[Gentiletti]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Villa]]></surname>
<given-names><![CDATA[AR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The GLADEL multinational Latin American prospective inception cohort of 1,214 patients with systemic lupus erythematosus ethnic and disease heterogeneity among &amp;raquo;,» &amp;reg;,® &amp;sect;,§ &amp;shy;,­ &amp;sup1;,¹ &amp;sup2;,² &amp;sup3;,³ &amp;szlig;,ß &amp;THORN;,Þ &amp;thorn;,þ &amp;times;,× &amp;Uacute;,Ú &amp;uacute;,ú &amp;Ucirc;,Û &amp;ucirc;,û &amp;Ugrave;,Ù &amp;ugrave;,ù &amp;uml;,¨ &amp;Uuml;,Ü &amp;uuml;,ü &amp;Yacute;,Ý &amp;yacute;,ý &amp;yen;,¥ &amp;yuml;,ÿ &amp;para;,¶ Hispanics &amp;raquo;,» &amp;reg;,® &amp;sect;,§ &amp;shy;,­ &amp;sup1;,¹ &amp;sup2;,² &amp;sup3;,³ &amp;szlig;,ß &amp;THORN;,Þ &amp;thorn;,þ &amp;times;,× &amp;Uacute;,Ú &amp;uacute;,ú &amp;Ucirc;,Û &amp;ucirc;,û &amp;Ugrave;,Ù &amp;ugrave;,ù &amp;uml;,¨ &amp;Uuml;,Ü &amp;uuml;,ü &amp;Yacute;,Ý &amp;yacute;,ý &amp;yen;,¥ &amp;yuml;,ÿ &amp;para;,¶]]></article-title>
<source><![CDATA[Medicine (Baltimore)]]></source>
<year>2004</year>
<volume>83</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>1-17</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pons-Estel]]></surname>
<given-names><![CDATA[GJ]]></given-names>
</name>
<name>
<surname><![CDATA[Alarcón]]></surname>
<given-names><![CDATA[GS]]></given-names>
</name>
<name>
<surname><![CDATA[Scofield]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Reinlib]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Cooper]]></surname>
<given-names><![CDATA[GS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Understanding the epidemiology and progression of systemic lupus erythematosus]]></article-title>
<source><![CDATA[Semin Arthritis Rheum]]></source>
<year>2010</year>
<volume>39</volume>
<page-range>257-68</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fanouriakis]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Kostopoulou]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Alunno]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Aringer]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Bajema]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Boletis]]></surname>
<given-names><![CDATA[JN]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[2019 update of the EULAR recommendations for the management of systemic lupus erythematosus]]></article-title>
<source><![CDATA[Ann Rheum Dis]]></source>
<year>2019</year>
<volume>78</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>736-45</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ruiz-Irastorza]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Danza]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Khamashta]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Tratamiento del lupus eritematoso sistémico mitos, certezas y dudas]]></article-title>
<source><![CDATA[Med Clin (Barc)]]></source>
<year>2013</year>
<volume>141</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>533-42</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gladman]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Ginzler]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Goldsmith]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Fortin]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Liang]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Urowitz]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The development and initial validation of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index for systemic lupus erythematosus]]></article-title>
<source><![CDATA[Arthritis Rheum]]></source>
<year>1996</year>
<volume>39</volume>
<page-range>363-9</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Alba]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Gómez-Puerta]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Goycochea-Robles]]></surname>
<given-names><![CDATA[MV]]></given-names>
</name>
<name>
<surname><![CDATA[Amigo]]></surname>
<given-names><![CDATA[MC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Organ Damage and Quality of Life in Antiphospholipid Syndrome]]></article-title>
<source><![CDATA[Curr Rheumatol Rep]]></source>
<year>2016</year>
<volume>18</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>7</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rivest]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Lew]]></surname>
<given-names><![CDATA[RA]]></given-names>
</name>
<name>
<surname><![CDATA[Welsing]]></surname>
<given-names><![CDATA[PM]]></given-names>
</name>
<name>
<surname><![CDATA[Sangha]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Wright]]></surname>
<given-names><![CDATA[EA]]></given-names>
</name>
<name>
<surname><![CDATA[Roberts]]></surname>
<given-names><![CDATA[WN]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Association between clinical factors, socioeconomic status, and organ damage in recent onset systemic lupus erythematosus]]></article-title>
<source><![CDATA[J Rheumatol]]></source>
<year>2000</year>
<volume>27</volume>
<page-range>680-4</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ruiz-Irastorza]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Danza]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Khamashta]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Glucocorticoids use and abuse in SLE]]></article-title>
<source><![CDATA[Rheumatology]]></source>
<year>2012</year>
<volume>51</volume>
<page-range>1145-53</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ruiz-Irastorza]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Ramos-Casals]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Brito-Zeron]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Khamashta]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinical efficacy and side effects of antimalarials in systemic lupus erythematosus a systematic review]]></article-title>
<source><![CDATA[Ann Rheum Dis]]></source>
<year>2010</year>
<volume>69</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>20-8</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pons-Estel]]></surname>
<given-names><![CDATA[BA]]></given-names>
</name>
<name>
<surname><![CDATA[Bonfa]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Soriano]]></surname>
<given-names><![CDATA[ER]]></given-names>
</name>
<name>
<surname><![CDATA[Cardiel]]></surname>
<given-names><![CDATA[MH]]></given-names>
</name>
<name>
<surname><![CDATA[Izcovich]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Popoff]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[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)]]></article-title>
<source><![CDATA[Ann Rheum Dis]]></source>
<year>2018</year>
<volume>77</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>1549-57</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Moroni]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Ponticelli]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Synthetic pharmacotherapy for lupus nephritis]]></article-title>
<source><![CDATA[Expert Opin Pharmacother]]></source>
<year>2017</year>
<volume>18</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>175-86</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bertsias]]></surname>
<given-names><![CDATA[GK]]></given-names>
</name>
<name>
<surname><![CDATA[Tektonidou]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Amoura]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
<name>
<surname><![CDATA[Aringer]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Bajema]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Berden]]></surname>
<given-names><![CDATA[JH]]></given-names>
</name>
<name>
<surname><![CDATA[Boletis]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Joint European League Against Rheumatism and European Renal Association-European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for the management of adult and paediatric lupus nephritis]]></article-title>
<source><![CDATA[Ann Rheum Dis]]></source>
<year>2012</year>
<volume>71</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>1771-82</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mok]]></surname>
<given-names><![CDATA[CC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Current role of rituximab in systemic lupus erythematosus]]></article-title>
<source><![CDATA[Int J Rheum Dis]]></source>
<year>2015</year>
<volume>18</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>154-63</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Thong]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Olsen]]></surname>
<given-names><![CDATA[NJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Systemic lupus erythematosus diagnosis and management]]></article-title>
<source><![CDATA[Rheumatology (Oxford)]]></source>
<year>2017</year>
<volume>56</volume>
<numero>suppl1</numero>
<issue>suppl1</issue>
<page-range>i3-i13</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ugarte]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Danza]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Ruiz-Irastorza]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Glucocorticoids and antimalarials in systemic lupus erythematosus an update and future directions]]></article-title>
<source><![CDATA[Curr Opin Rheumatol]]></source>
<year>2018</year>
<volume>30</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>482-9</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Zonana-Nacach]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Barr]]></surname>
<given-names><![CDATA[SG]]></given-names>
</name>
<name>
<surname><![CDATA[Magder]]></surname>
<given-names><![CDATA[LS]]></given-names>
</name>
<name>
<surname><![CDATA[Petri]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Damage in systemic lupus erythematosus and its association with corticosteroids]]></article-title>
<source><![CDATA[Arthritis Rheum]]></source>
<year>2000</year>
<volume>43</volume>
<page-range>1801-8</page-range></nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ruiz-Irastorza]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Olivares]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Ruiz-Arruza]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Martinez-Berriotxoa]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Egurbide]]></surname>
<given-names><![CDATA[MV]]></given-names>
</name>
<name>
<surname><![CDATA[Aguirre]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Predictors of major infections in systemic lupus erythematosus]]></article-title>
<source><![CDATA[Arthritis Res Ther]]></source>
<year>2009</year>
<volume>11</volume>
<page-range>R109</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Danza]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Ruiz-Irastorza]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Infection risk in systemic lupus erythematosus patients susceptibility factors and preventive strategies]]></article-title>
<source><![CDATA[Lupus]]></source>
<year>2013</year>
<volume>22</volume>
<page-range>1286-94</page-range></nlm-citation>
</ref>
<ref id="B21">
<label>21</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ruiz-Irastorza]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Ugarte]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Ruiz-Arruza]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Khamashta]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Seventy years after Hench&amp;apos;s Nobel prize revisiting the use of glucocorticoids in systemic lupus erythematosus]]></article-title>
<source><![CDATA[Lupus]]></source>
<year>2020</year>
<volume>29</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>1155-67</page-range></nlm-citation>
</ref>
<ref id="B22">
<label>22</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ruiz-Irastorza]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Danza]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Perales]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Villar]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Garcia]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Delgado]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prednisone in lupus nephritis how much is enough?]]></article-title>
<source><![CDATA[Autoimmun Rev]]></source>
<year>2014</year>
<volume>13</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>206-14</page-range></nlm-citation>
</ref>
<ref id="B23">
<label>23</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hochberg]]></surname>
<given-names><![CDATA[MC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus]]></article-title>
<source><![CDATA[Arthritis Rheum]]></source>
<year>1997</year>
<volume>40</volume>
<page-range>1725</page-range></nlm-citation>
</ref>
<ref id="B24">
<label>24</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gladman]]></surname>
<given-names><![CDATA[DD]]></given-names>
</name>
<name>
<surname><![CDATA[Ibañez]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Urowitz]]></surname>
<given-names><![CDATA[MB]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Systemic lupus erythematosus disease activity index 2000]]></article-title>
<source><![CDATA[J Rheumatol]]></source>
<year>2002</year>
<volume>29</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>288-91</page-range></nlm-citation>
</ref>
<ref id="B25">
<label>25</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bañez]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Gladman]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Urowitz]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Summarizing disease features over time II. Variability measures of SLEDAI-2K]]></article-title>
<source><![CDATA[J Rheumatol]]></source>
<year>2007</year>
<volume>34</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>336-40</page-range></nlm-citation>
</ref>
<ref id="B26">
<label>26</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Al Sawah]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Zhang]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Zhu]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Magder]]></surname>
<given-names><![CDATA[LS]]></given-names>
</name>
<name>
<surname><![CDATA[Foster]]></surname>
<given-names><![CDATA[SA]]></given-names>
</name>
<name>
<surname><![CDATA[Iikuni]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Petri]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Effect of corticosteroid use by dose on the risk of developing organ damage over time in systemic lupus erythematosus-the Hopkins Lupus Cohort]]></article-title>
<source><![CDATA[Lupus Sci Med]]></source>
<year>2015</year>
<volume>2</volume>
<numero>1</numero>
<issue>1</issue>
</nlm-citation>
</ref>
<ref id="B27">
<label>27</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ruiz-Arruza]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Ugarte]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Cabezas-Rodriguez]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Medina]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Moran]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<name>
<surname><![CDATA[Ruiz-Irastorza]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Glucocorticoids and irreversible damage in patients with systemic lupus erythematosus]]></article-title>
<source><![CDATA[Rheumatology (Oxford)]]></source>
<year>2014</year>
<volume>53</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>1470-6</page-range></nlm-citation>
</ref>
<ref id="B28">
<label>28</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ruiz-Arruza]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Barbosa]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Ugarte]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Ruiz-Irastorza]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Comparison of high versus low-medium prednisone doses for the treatment of systemic lupus erythematosus patients with high activity at diagnosis]]></article-title>
<source><![CDATA[Autoimmun Rev]]></source>
<year>2015</year>
<volume>14</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>875-9</page-range></nlm-citation>
</ref>
<ref id="B29">
<label>29</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Apostolopoulos]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Kandane-Rathnayake]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Raghunath]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Hoi]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Nikpour]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Morand]]></surname>
<given-names><![CDATA[EF]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Independent association of glucocorticoids with damage accrual in SLE]]></article-title>
<source><![CDATA[Lupus Sci Med]]></source>
<year>2016</year>
<volume>3</volume>
<numero>1</numero>
<issue>1</issue>
</nlm-citation>
</ref>
<ref id="B30">
<label>30</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ruiz-Irastorza]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Khamashta]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hydroxychloroquine the cornerstone of lupus therapy]]></article-title>
<source><![CDATA[Lupus]]></source>
<year>2008</year>
<volume>17</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>271-3</page-range></nlm-citation>
</ref>
<ref id="B31">
<label>31</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Stahn]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Buttgereit]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Genomic and nongenomic effects of glucocorticoids]]></article-title>
<source><![CDATA[Nat Clin Pract Rheumatol]]></source>
<year>2008</year>
<volume>4</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>525-33</page-range></nlm-citation>
</ref>
<ref id="B32">
<label>32</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Strehl]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Buttgereit]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Optimized glucocorticoid therapy teaching old drugs new tricks]]></article-title>
<source><![CDATA[Mol Cell Endocrinol]]></source>
<year>2013</year>
<volume>380</volume>
<numero>1-2</numero>
<issue>1-2</issue>
<page-range>32-40</page-range></nlm-citation>
</ref>
<ref id="B33">
<label>33</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Apostolopoulos]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Morand]]></surname>
<given-names><![CDATA[EF]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[It hasn&amp;apos;t gone away the problem of glucocorticoid use in lupus remains]]></article-title>
<source><![CDATA[Rheumatology (Oxford)]]></source>
<year>2017</year>
<volume>56</volume>
<numero>suppl_1</numero>
<issue>suppl_1</issue>
<page-range>i114-22</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
