2025 ACR SLE Guideline Prioritizes Hydroxychloroquine and Glucocorticoid Minimization

The American College of Rheumatology reframes non-renal SLE management around universal hydroxychloroquine, aggressive glucocorticoid tapering, and earlier immunosuppressive escalation.

📅 Journal publication: Jul 2026 (online Nov 4, 2025) · Last updated: Jul 21, 2026

2025 ACR SLE GuidelineAmerican College of Rheumatologysystemic lupus erythematosushydroxychloroquineglucocorticoidsbiologic immunosuppressants Rheumatology / Immunology

Background Information

New guidelines unify SLE treatment strategies for better outcomes.

Systemic lupus erythematosus (SLE) significantly impacts morbidity and mortality; uniform guidelines enhance treatment efficacy. Consensus was reached on recommendations, including hydroxychloroquine use, short-term glucocorticoids, and early immunosuppressives. The guideline promotes evidence-based management for SLE, encouraging shared decision-making while recognizing individual patient needs. This guideline offers a unified approach to manage SLE, aiming to minimize disease activity and treatment toxicity.

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Authors: Sammaritano LR, Askanase A, Bermas BL, Dall'Era M, Duarte-García A, Hiraki LT, Son MBF, Werth VP, Aranow C, Barnado A, Broder A, Brunner HI, Chong BF, Chowdhary VR, Hersh AO, Izmirly PM, Jules M, Kalunian K, Kamen D, Rubinstein TB, Smith BJ, Smith NM, Thomas A, Timlin H, Wallace DJ, Azzam M, Bartels CM, Cunha JS, DeQuattro K, Fava A, Figueroa-Parra G, Garg S, Gomes LLA, Cuéllar-Gutiérrez MC, Iyer P, Johannemann AS, Jorge A, Kasturi S, Kawtharany H, Khawandi J, Legge A, Liang KP, Lockwood MM, Sanchez-Rodriguez A, Turgunbaev M, Williams JN, Turner AS, Mustafa RA

Citation: Sammaritano LR, Askanase A, Bermas BL, et al. 2025 American College of Rheumatology (ACR) Guideline for the Treatment of Systemic Lupus Erythematosus. Arthritis & rheumatology (Hoboken, N.J.). 2026;78(7):1361-1386. doi:10.1002/art.43452

Article Links: PubMed · Journal / DOI

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