Hydroxychloroquine is an appropriate agent to address milder systemic manifestations of systemic lupus erythematosus (SLE) such as arthritis and pericarditis, and it can act as a glucocorticoid-sparing agent. All patients with SLE who can tolerate it should be taking hydroxychloroquine. Antimalarial therapy such as hydroxychloroquine in SLE has documented benefit for reducing disease activity, improving survival, and reducing the risk of SLE-related thrombosis and myocardial infarction.

Azathioprine is generally reserved for more severe manifestations of SLE not responsive to low-dose prednisone and hydroxychloroquine but can be associated with serious toxicity. Azathioprine has generally been supplanted by the use of mycophenolate mofetil in SLE.

Mycophenolate mofetil may be appropriate for this patient if she had more serious disease activity such as nephritis or if her arthritis or pericarditis recurred while taking hydroxychloroquine.

NSAIDs, often with colchicine, are first-line therapy for most patients with pericarditis, although glucocorticoids may be indicated in patients with pericarditis associated with a systemic inflammatory disease such as in this patient. However, there is no indication to start an NSAID now given resolution of her symptoms, and doing so would increase her risk of gastrointestinal complications if used along with her daily glucocorticoid.