EULAR recommendations for the management of systemic lupus erythematosus with kidney involvement: 2025 update

作者：Antonis Fanouriakis, Myrto Kostopoulou, Hans‐Joachim Anders, Jeanette Viggen Andersen, Martin Aringer, Michael William Beresford, Andrea. Schwartz Doria, Eleni A. Frangou, Richard Alan Furie, Dafna D Gladman, Frédéric A. Houssiau, Alexandre Karras, Marios Kouloumas, Anastasia‐Vasiliki Madenidou, Ana Malvar, Smaragdi Marinaki, Chi Chiu Mok, Gabriella Luisa Moroni, Ioannis Parodis, Simona Rednic, C. Sieiro Santos, Carlo Alberto Scirè, Josef S Smolen, Farah Tamirou, Yoshiya Tanaka, Y K Onno Teng, Elisabet Welin, George Βertsias, Dimitrios T. Boumpas · 发表于：Annals of the Rheumatic Diseases · 年份：2025 · DOI：10.1016/j.ard.2025.09.007 · 被引用次数：96 · 研究领域：Systemic Lupus Erythematosus Research、Rheumatoid Arthritis Research and Therapies、Renal Transplantation Outcomes and Treatments

OBJECTIVES: The objective of this study was to update the 2019 European Alliance of Associations for Rheumatology (EULAR)/ European Renal Association/European Dialysis Transplantation Association (ERA-EDTA) recommendations for the management of systemic lupus erythematosus (SLE) with kidney involvement, taking into consideration emerging evidence and recent developments in the field. METHODS: We recruited an international Task Force of experts and followed the EULAR standard operating procedures. We performed systematic literature research (period January 2019 to March 2024), followed by the modified Delphi method, to form questions, elicit expert opinions, and reach consensus. The new evidence was examined, taking into consideration previous updates. RESULTS: The Task Force agreed on 4 overarching principles and 13 recommendations, which were also evaluated for their feasibility and impact on clinical care. These concern the use of kidney biopsy for diagnosis; targets of therapy and treatment milestones; immunomodulatory therapy with antimalarials, glucocorticoids, immunosuppressives (mycophenolate, cyclophosphamide, and calcineurin inhibitors), and biologics (belimumab, obinutuzumab, and rituximab); nonimmune therapy (kidney protection, vaccinations, cardiovascular, and bone protection); family planning; and management of kidney failure. Guidance on single-agent or early combination immune therapy, glucocorticoid tapering and withdrawal, duration of immune therapy, and trea...