EULAR publishes updated recommendations for the management of SLE

SLE is a heterogeneous disease, which can cause many different manifestations and symptoms, and traditionally has not had many treatment options. However, the picture is changing and clinical practice must change accordingly, to keep up with modern treatment options and to take full advantage of new drugs that can target key pathophysiological pathways. Accordingly, EULAR has updated its recommendations for the management of SLE.

The updated recommendations were developed by a multidisciplinary working group of patient research partners and healthcare professionals. Work was completed in accordance with EULAR standard operating procedures. All of the information included in the final publication – published in the October 2023 issue of the Annals of the Rheumatic Diseases – was based on a systematic literature review.

In total, 5 general principles and 13 recommendations were developed. The principles reinforce the need for multidisciplinary, individualized management alongside patient education and shared decision-making—and suggest that both patient and societal costs be considered. It is recommended that disease activity be assessed at each clinic visit and organ damage checked at least annually. Non-pharmacological interventions can have an impact and improve long-term outcomes. Pharmacological treatments should be selected based on the individual characteristics and preferences of each individual, as well as the type of disease, the severity of organ involvement, and any comorbidities. Early diagnosis, regular screening for new organ manifestations, early treatment – and strict adherence to the latter – are essential to prevent flare-ups and organ damage, as well as improve long-term outcomes and improve people’s quality of life.

Individual recommendations cover treatment options for specific circumstances, such as when people have kidney or nervous system involvement in their disease. Instructions are also given on the dosage and timing of glucocorticoids, the use of conventional and biologic immunosuppressive drugs, and how and when to taper therapy once response is achieved.

These recommendations represent the current state-of-the-art guidance for SLE, and EULAR hopes that they will provide guidance on pharmacological interventions for physicians worldwide – and for their patients with SLE.