2025 ACR guideline for the treatment of SLE

The 2025 American College of Rheumatology (ACR) guideline for the treatment of systemic lupus erythematosus (SLE) provides evidence-based recommendations for the management of SLE in children and adults. Recommendations were published by Sammaritano et al. in Arthritis Care & Research.

Key data: The guideline recommends hydroxychloroquine (HCQ) as standard therapy, limiting glucocorticoid exposure, and early introduction of conventional and/or biologic immunosuppressive therapies to achieve remission or low disease activity while minimizing toxicity for all people with SLE. Since multiple factors influence therapy choice, the guideline highlights the role of shared decision-making between patients and clinicians to allow people with SLE to choose optimal medications in terms of efficacy, tolerability, and availability.

Key learning: The 2025 ACR guideline emphasizes individualized treatment approaches based on disease severity, with glucocorticoid-sparing strategies prioritized to minimize toxicity while achieving optimal disease control across diverse SLE manifestations.