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

2b/C
9.40
(
0.75
)
Continued
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Ann Rheum Dis: first published as 10.1136/annrheumdis-2020-216924 on 27 March 2020. Downloaded from 

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716
Fanouriakis A, 
et al
. 
Ann Rheum Dis
2020;
79
:713–723. doi:10.1136/annrheumdis-2020-216924
Recommendation
Overarching principles
4.12 Continuation, switching to or addition of CNIs (especially TAC) can be considered in pure class V nephritis at the lowest effective 
dose and after considering nephrotoxicity risks.
2b/b
9.28
(
1.15
)
non- responding/refractory disease
4.13 In case of failure to achieve the treatment goals, thorough evaluation of the possible causes is recommended, including assessment 
of adherence to treatment and therapeutic drug monitoring.