The 2026 British Society for Rheumatology guideline for the management of children, young people and adults with systemic lupus erythematosus

Abstract

Abstract Systemic lupus erythematosus (SLE) is a lifelong autoimmune condition with multi-system involvement that is associated with morbidity, mortality, and poor quality of life. The key aim of management should be to empower individuals with SLE to manage their condition, suppressing systemic disease activity, and preventing organ damage. This guideline builds on and expands the recommendations developed for the first guideline published in 2017 for adults living with SLE. This comprehensive life-course guideline was developed according to the British Society for Rheumatology Guidelines Protocol by a Guideline Working Group (GWG) comprising healthcare professionals with expertise in paediatric and adult SLE, and people with lived experience. The GWG reviewed published guidelines, undertook a systematic literature review and utilised expertise from specialist lupus centres across the UK and patient representatives to formulate a list of 102 recommendations with corresponding strength of recommendations and agreement scores. These recommendations encompass advances in the assessment, diagnosis, monitoring, general approaches to management, non-pharmacological and pharmacological management of SLE, organ-specific treatment including lupus nephritis and cutaneous lupus erythematosus, as well as the delivery of care in the context of the UK healthcare system. Furthermore, we have provided research and audit recommendations to support equitable access to care and improve health outcomes in SLE.