ACR Releases New Guideline for Management of SLE at ACR 2025

One audience member asked about the mention of IL-1 inhibition without specific data of its efficacy in SLE pericarditis. “Clinicians seek practical guidance, even when it must rely on expert consensus or case series in the absence of clinical trials or high-quality evidence,” Dr. Duarte-Garcia responded.

Mithu Maheswaranathan, MD, is an assis­tant professor of medicine in the Division of Rheumatology at Duke University School of Medicine, Durham, N.C. and can be followed on X/Twitter @MithuRheum.

References

1. Sammaritano LR, Askanase A, Bermas BL, et al. 2025 American College of Rheumatology (ACR) guideline for the treatment of systemic lupus erythematosus. https://rheumatology.org/lupus-guideline.
2. Ryu S, Fu W, Petri MA. Associates and predictors of pleurisy or pericarditis in SLE. Lupus Sci Med. 2017 Oct 23;4(1):e000221.
3. Ordi-Ros J, Sáez-Comet L, Pérez-Conesa M, et al. Enteric-coated mycophenolate sodium versus azathioprine in patients with active systemic lupus erythematosus: A randomised clinical trial. Ann Rheum Dis. 2017 Sep;76(9):1575–1582.
4. Manzi S, Sánchez-Guerrero J, Merrill JT, et al. Effects of belimumab, a B lymphocyte stimulator-specific inhibitor, on disease activity across multiple organ domains in patients with systemic lupus erythematosus: Combined results from two phase III trials. Ann Rheum Dis. 2012 Nov;71(11):1833–1838.
5. Morand EF, Furie RA, Bruce IN, et al. Efficacy of anifrolumab across organ domains in patients with moderate-to-severe systemic lupus erythematosus: A post-hoc analysis of pooled data from the TULIP-1 and TULIP-2 trials. Lancet Rheumatol. 2022 Apr;4(4):e282–e292.
6. Imazio M, Andreis A, Piroli F, et al. Anti-interleukin 1 agents for the treatment of recurrent pericarditis: A systematic review and meta-analysis. Heart. 2021 Jul 12;107(15):1240–1245.
7. Fanouriakis A, Adamichou C, Koutsoviti S, et al. Low disease activity-irrespective of serologic status at baseline-associated with reduction of corticosteroid dose and number of flares in patients with systemic lupus erythematosus treated with belimumab: A real-life observational study. Semin Arthritis Rheum. 2018 Dec;48(3):467–474.
8. Iaccarino L, Bettio S, Reggia R, et al. Effects of belimumab on flare rate and expected damage progression in patients with active systemic lupus erythematosus. Arthritis Care Res (Hoboken). 2017 Jan;69(1):115–123.
9. Merrill JT, Furie R, Werth VP, et al. Anifrolumab effects on rash and arthritis: Impact of the type I interferon gene signature in the phase IIb MUSE study in patients with systemic lupus erythematosus. Lupus Sci Med. 2018 Nov 26;5(1):e000284.
10. Furie RA, Morand EF, Bruce IN, et al. Type I interferon inhibitor anifrolumab in active systemic lupus erythematosus (TULIP-1): A randomised, controlled, phase 3 trial. Lancet Rheumatol. 2019 Dec;1(4):e208–e219.
11. Morand EF, Furie R, Tanaka Y, et al. Trial of anifrolumab in active systemic lupus erythematosus. N Engl J Med. 2020 Jan 16;382(3):211–221.
12. Tanaka Y, Tummala R. Anifrolumab, a monoclonal antibody to the type I interferon receptor subunit 1, for the treatment of systemic lupus erythematosus: An overview from clinical trials. Mod Rheumatol. 2021 Jan;31(1):1–12.
13. Rubinstein TB, Dionizovik-Dimanovski M, Davis AM, et al. Multicenter study of utility and acceptability of depression and anxiety screening in adolescents and young adults with childhood-onset systemic lupus. Arthritis Care Res (Hoboken). 2023 Apr;75(4):724–733.
14. Cunningham NR, Danguecan AN, Ely SL, et al. American College of Rheumatology guidance statements for addressing mental health concerns in youth with pediatric rheumatologic diseases. Arthritis Care Res (Hoboken). 2025 Aug;77(8):953–964.
15. White PH, Ardoin S. Transitioning wisely: Improving the connection from pediatric to adult health care. Arthritis Rheumatol. 2016 Apr;68(4):789–794.