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Consider: More frequent assessments during dose escalation (first 4-5 months) to evaluate tolerability, side effects, and any changes in lupus disease activity Regular reviews once on maintenance dosing, coordinated with routine rheumatology appointments where possible Weight and BMI tracking to assess treatment efficacy Blood pressure monitoring at consultations, as weight loss should improve hypertension but requires documentation Laboratory monitoring should be tailored to individual risk factors: Renal function tests (creatinine, eGFR, urinalysis) as appropriate for the patient's baseline renal status, with increased frequency if significant gastrointestinal side effects occur Lupus disease markers (complement levels, anti-dsDNA antibodies, inflammatory markers) as per the patient's usual monitoring schedule, with additional testing if symptoms suggest a flare Lipid profile and HbA1c to track metabolic improvements INR monitoring for patients on warfarin, particularly when starting or adjusting semaglutide dosing Thyroid function tests for patients on levothyroxine Patient safety advice is paramount

It is very important that individualized surgical decisions should be made according to life expectancy, underlying comorbidities, and the patients wishes