Extra-Renal Manifestations of Lupus Nephritis From the College | August 7, 2025 The ACR recently released a new guideline on the screening, treatment and overall management of lupus nephritis in children and adults. It includes immunosuppressive treatment recommendations for moderate to severe extra-renal manifestations of lupus nephritis. These recommendations should not be used to limit or deny access to therapies because treatment decisions may vary due to the unique clinical situation and personal preferences of each individual patient. In people with active, new-onset or flare of Class III/IV (±V) LN with moderate to severe extra-renal manifestations, the guideline conditionally recommends a triple immunosuppressive therapy consisting of intravenous glucocorticoids (250–1,000 mg methylprednisolone daily for one to three days) followed by oral glucocorticoids (≤0.5 mg/kg/day, maximum dose 40 mg/day) and: A. Belimumab B. Voclosporin C. Hydroxychloroquine D. None of the above None Time's up
