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| 2025 American College of Rheumatology (ACR) guideline for the treatment of systemic lupus erythematosus |
| Sammaritano LR, Askanase A, Duarte-García A, Aranow C, Bermas BL, Hiraki LT, Dall'Era M, Son MBF, Werth VP, Barnado A, Brunner HI, Broder A, Chong BF, Chowdhary VR, Hersh AO, Izmirly PM, Jules M, Kalunian K, Kamen D, Rubinstein TB, Smith BJ, Smith NM, Thomas A, Timlin H, Wallace DJ, DeQuattro K, Azzam M, Bartels CM, Cunha JS, Fava A, Figueroa-Parra G, Garg S, Gomes LLA, Cuéllar-Gutiérrez MC, Iyer P, Johannemann AS, Jorge A, Kasturi S, Kawtharany H, Khawandi J, Legge A, Liang KP, Lockwood MM, Sanchez-Rodriguez A, Williams JN, Turner AS, Turgunbaev M, Mustafa RA [American College of Rheumatology] |
| Arthritis Care & Research 2025 Feb 3;0(0):pp 1–25 |
| practice guideline |
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OBJECTIVE: To provide evidence-based and expert guidance for the treatment and management of non-renal systemic lupus erythematosus (SLE); treatment and management of lupus nephritis are addressed in a separate guideline. METHODS: Clinical questions for treatment and management of SLE were developed in the PICO format (population, intervention, comparator, and outcome). Systematic literature reviews were developed for each PICO question, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology was used to assess evidence quality and formulate recommendations. The Voting Panel achieved a consensus of >= 70% agreement on the direction (for or against) and strength (strong or conditional) of each recommendation. RESULTS: We present recommendations and ungraded, consensus-based good practice statements for the treatment and management of SLE that are applicable to pediatric and adult patients. Recommendations emphasize uniform treatment with hydroxychloroquine, limiting duration of glucocorticoid use, and early introduction of conventional and/or biologic immunosuppressive therapies to achieve and maintain control of SLE inflammation (remission or a low level of disease activity), reduce SLE-related morbidity and mortality, and minimize medication-related toxicities. CONCLUSION: This guideline presents direction regarding treatment and management of SLE and provides a foundation for well-informed, shared clinician-patient decision-making. These recommendations should not be used to limit or deny access to therapies, as treatment decisions may vary due to the unique clinical situation and personal preferences of each person with SLE. https://rheumatology.org/lupus-guideline#2025-sle-guideline
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