Because lupus is a complex and highly individualized disease, treatment guidelines play an important role in helping patients and doctors make treatment plans. As Dr. Aranow explains, “Treatment guidelines are just that: They’re guidelines to provide state of the art evidence on how to best treat a condition.” They are evidence-based recommendations, not rigid rules, designed to support consistent care across health care settings.
The updated ACR guidelines go beyond medication choices alone. They also address disease monitoring, prevention of long-term damage, vaccinations, bone health, cardiovascular risk and cancer screening — all essential components of comprehensive lupus management. A major shift in the new guidelines is the emphasis on clearly defined treatment goals. “The target is remission, which is absence of any clinical disease activity, or if this can’t be reached, then a state of what we call ‘low clinical disease activity,’” Dr. Aranow explains.
Another key priority is reducing long-term steroid use. While steroids can be effective in quickly controlling inflammation, they are associated with significant long-term side effects. The guidelines encourage early use of immunosuppressants to allow decreasing steroid dosage and ultimately discontinuing steroids whenever possible.
Dr. Aranow especially emphasizes the importance of shared decision-making and open communication between patients and their health care providers. “We’re at a time that we’re talking about remission and low disease activity [as goals of treatment]. These are possible. They’re attainable,” she says, pointing to advances in treatments and ongoing research.
Listen to this episode of The Expert Series to learn more about treatment guidelines, and explore additional resources and support through the National Resource Center on Lupus. The more you learn, the more informed and empowered you can become in your care.
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