Question: is this a 2) strong advice, 1) weak advice 0) no advice?

In addition, serum creatinine shows a paradoxical inverse relationship with disease relapse; higher serum creatinine levels are associated with lower risk of relapse.4 Therefore, although localized and early systemic GPA lack organ or life-threatening manifestations, persistent granulomatous inflammation is difficult to treat and exposes patients to significant risks associated with long-term immunosuppression.23 The use of methotrexate, in combination with glucocorticoids, has been advocated following a randomized controlled trial, which demonstrated its equivalence at inducing remission in early systemic disease compared to oral cyclophosphamide. 
user
This is no advice
assistant