Today at the American College of Rheumatology (ACR) Annual Meeting, Convergence 2025, the ACR held a discussion of the new guidelines for the treatment and management of systemic lupus erythematosus (SLE), the most common form of lupus. These guidelines provide an update from the 1999 guidelines when disease management was limited to a small number of available therapies, and there have been important changes in the understanding of optimal use of standard rheumatology therapies.
The new guidelines include three strong recommendations:
- Taper prednisone dose to <5 mg daily within six months,
- Universal treatment with hydroxychloroquine (absent contraindications) to prevent flares and reduce accrual of damage, and
- Prompt escalation in therapy if initial therapy is insufficient to achieve disease control.
The hope for the new guidelines and recommendations is to provide more universal use of optimal disease management for people with SLE and reduce barriers to care. There are 36 recommendations within the guidelines, which are expected to be shared in full to the public in the coming weeks.
The new guidelines also have a focus on organ-specific disease, including musculoskeletal, cutaneous, hematologic and neurologic manifestations.
During this morning’s Convergence 2025 session, new information was shared around applying the guidelines to children and adolescents with SLE, including considerations around the impact of high dose glucocorticoids and their potential impact on development, as well as the commonality of depression, anxiety and suicidal ideation. The guidelines will include assessment and management of mental health among children and adolescents with SLE. The session also highlighted the importance of shared decision making between doctor and patient.
The Lupus Foundation of America was proud to support the development of these guidelines by connecting people with lupus to participate in the patient panel and provide valuable experiences for the guidelines development.
Once the full guidelines are released, the Lupus Foundation of America will share them with the lupus community and continue to report on any updates or developments.
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