News Release

Updated: SLE management

2023 recommendations for SLE

Peer-Reviewed Publication

European Alliance of Associations for Rheumatology (EULAR)

SLE is a heterogeneous disease, which can cause many different manifestations and symptoms, and traditionally did not have many treatment options. However, the picture is changing, and clinical practice must change accordingly, to keep up with modern treatment options and to make the most of new drugs that can target key pathophysiological pathways. In line with this, EULAR has updated its recommendations for managing SLE.

The updated recommendations were developed by a multidisciplinary task force of patient research partners and healthcare professionals. The work was completed in line with EULAR standardized operating procedures. All information included in the final publication – published in the month of October 2023 issue of the Annals of the Rheumatic Diseases – was based on a systematic literature review.

Overall, 5 overarching principles and 13 recommendations were developed. The principles reinforce the need for multidisciplinary, individualized management alongside patient education and shared decision-making – and suggest considering both patient and societal costs. 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 chosen based on each person’s individual characteristics and preferences, as well as their disease type, severity of organ involvement, and any comorbidities. Early diagnosis, regular screening for new organ manifestations, prompt treatment, – and strict adherence to the latter – are essential to prevent flares and organ damage, as well as to improve the long-term outcome, and enhance people’s quality of life.

The individual recommendations cover treatment choices for specific circumstances, such as when people have kidney or nervous system involvement in their disease. Guidance is also given around dosing and timing for glucocorticoids, use of conventional and biologic immunosuppressive drugs, and how and when to taper treatment once response is achieved.

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

Fanouriakis A, Kostopoulou M, Andersen J, et al EULAR recommendations for the management of systemic lupus erythematosus: 2023 update Annals of the Rheumatic Diseases Published Online First: 12 October 2023. doi: 10.1136/ard-2023-224762


EULAR is the European umbrella organisation representing scientific societies, health professional associations and organisations for people with rheumatic and musculoskeletal diseases (RMDs). EULAR aims to reduce the impact of RMDs on individuals and society, as well as improve RMD treatments, prevention, and rehabilitation. To this end, EULAR fosters excellence in rheumatology education and research, promotes the translation of research advances into daily care, and advocates for the recognition of the needs of those living with RMDs by EU institutions.



EULAR Communications,


Notes to Editors

EULAR Recommendations

EULAR School of Rheumatology

EULAR Press Releases

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