What maintenance regimen do you use for a patient with lupus cerebritis?

I prefer a mycophenolate analogue (MPA, usually mycophenolate mofetil, MMF, but prefer mycophenolic acid if on a PPI, which causes reduced MMF bioavailability, or if MMF intolerant) over azathioprine (AZA) for maintenance.

Reasoning is that MPAs have shown better efficacy in improving outcomes and pr...

This is a patient with ‘lupus cerebritis’ and transverse myelitis. I would consider the diagnosis of neuromyelitis optica spectrum disorder in this patient and check for the presence of autoantibodies against aquaporin-4. Optic neuritis is present only in two-thirds of the patients during the diseas...

As far as I am aware, and after performing a literature review, there are no studies comparing the benefits of mycophenolate vs azathioprine. Personal preference is to use mycophenolate unless pregnancy is a consideration, when azathioprine would be preferred. I would certainly use one or the other ...

Either mycophenolate or azathioprine are reasonable options; there is no data that would suggest one over the other for treatment of CNS lupus/TM. However, extrapolating data from the LN studies suggests that relative to what is observed with azathioprine, there is greater efficacy in relapse preven...