Newly published European guidelines for the management of systemic lupus erythematosus (SLE) and lupus nephritis, specifically recommending early and aggressive use of new medications, signal that the old paradigm of SLE management is shifting. Although it presents challenges, this shift is welcome — and is likely to have far-reaching implications.
This is a preview of subscription content, access via your institution
Access options
Access Nature and 54 other Nature Portfolio journals
Get Nature+, our best-value online-access subscription
$29.99 / 30 days
cancel any time
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
Fanouriakis, A. et al. EULAR recommendations for the management of systemic lupus erythematosus: 2023 update. Ann. Rheum. Dis. https://doi.org/10.1136/ard-2023-224762 (2023).
Fanouriakis, A. et al. 2019 update of the EULAR recommendations for the management of systemic lupus erythematosus. Ann. Rheum. Dis. 78, 736–745 (2019).
Fanouriakis, A. et al. 2019 update of the joint European League Against Rheumatism and European Renal Association–European Dialysis and Transplant Association (EULAR/ERA–EDTA) recommendations for the management of lupus nephritis. Ann. Rheum. Dis. 79, 713–723 (2020).
United States Food and Drug Administration. BENLYSTA (belimumab) label. FDA https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/125370s016lbl.pdf (2012).
United States Food and Drug Administration. SAPHNELO (anifrolumab-fnia) injection label. FDA https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/761123s000lbl.pdf (2021).
Kuhn, T.S. The Structure of Scientific Revolutions (Univ. Chicago Press, 1962).
Buie, J. et al. Disparities in lupus and the role of social determinants of health: current state of knowledge and directions for future research. ACR Open Rheumatol. https://doi.org/10.1002/acr2.11590 (2023).
Barber, M. R. W. et al. Global epidemiology of systemic lupus erythematosus: narrowing the knowledge gaps. Rheumatology (Oxford) 62, i4–i9 (2023).
Australian Rheumatology Association. How To Use This Guideline. in An Australian Living Guideline for the Pharmacological Management of Inflammatory Arthritis https://app.magicapp.org/#/guideline/LqRV3n (2023).
Acknowledgements
K.H.C. is supported by the US National Institutes of Health (NIH K24 AR066109).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
K.H.C. declares that she has received grants and/or research support from Amgen, AstraZeneca Exagen Diagnostics, Gilead, GlaxoSmithKline, and Janssen and has acted as a consultant for Amgen, Bristol-Myers Squibb, Cabaletta Bio, Eli Lilly, GlaxoSmithKlein and Janssen. J.J.E.K. declares no competing interests.
Rights and permissions
About this article
Cite this article
Koopman, J.J.E., Costenbader, K.H. Shifting the SLE management paradigm: challenges and implications. Nat Rev Rheumatol 20, 5–6 (2024). https://doi.org/10.1038/s41584-023-01058-5
Published:
Issue Date:
DOI: https://doi.org/10.1038/s41584-023-01058-5