Is it okay to use medications associated with drug-induced lupus in patients with SLE?

In the current era, I find it useful to divide drug-induced lupus into two classes. First, the traditional medications such as procainamide and hydralazine that are associated with ANA by IFA, anti-histone antibodies, and a type of drug induced lupus not characterized by certain clinical features such as nephritis or serological findings such as anti-dsDNA antibodies. Second, are the biological medication such as interferons and TNF antagonists which can induce anti-dsDNA and clinical disease more similar to idiopathic spontaneous disease. When used in the general population for both classes if drug induced lupus results recommend discontinuing the offending agent both because the clinical manifestations will improve and in most cases alternative options are available. The first group produces an illness that is clearly distinct from traditional SLE and as appropriate these drugs can be prescribed to lupus patients without fear of exacerbating underlying disease. I am unaware of any data lupus patients are at any increased risk for appearance of drug-induced illness than the general population. One point of clarification is sulfonamide antibiotics which I recommend avoiding in lupus unless there is documented PJP infection, given data that lupus patients have increased hypersensitivity reactions than the general population as well as increased disease exacerbation rates. There is greater hesitancy in using the second group in patients with preexisting lupus. Fortunately, direct antiviral agents have replaced the need for interferon to treat Hepatitis C. As far as TNF antagonists, I remain reluctant to prescribe in known SLE patients as alternatives exist for musculoskeletal disease beyond HCQ including MTX, AZA, MMF, belimumab, RTX, abatacept, IL-6 antagonists, and JAK inhibitors.