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The following is a summary of “2024 American College of Rheumatology (ACR) Guideline for the Screening, Treatment, and Management of Lupus Nephritis,” published in the March 2025 issue of American College of Rheumatology by Sammaritano et al.  

Researchers conducted a retrospective study to develop evidence-based, expert-informed recommendations for the screening, treatment, and management of lupus nephritis.  

They developed clinical questions for the screening, treatment, and management of lupus nephritis using the PICO format (population, intervention, comparator, and outcome). Systematic literature reviews were executed for every PICO question, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology was applied to evaluate evidence quality and form recommendations. The Voting Panel reached a consensus of ≥70% on the direction (for or against) and strength (strong or conditional) of individual recommendation.  

The results showed 28 graded recommendations (7 strong, 21 conditional) and 13 ungraded, consensus-based good practice statements for the screening and management of lupus nephritis. The recommendations emphasized that lupus nephritis therapy should be continuous and ongoing rather than separated into discrete induction/initial and maintenance/subsequent phases. Therapy should involve pulse glucocorticoids, heeded by oral glucocorticoid taper and 2 additional immunosuppressive agents for 3–5 years in individuals achieving complete renal response.  

Investigators concluded that this guideline provided direction for clinicians regarding screening and treatment decisions for the management of lupus nephritis but that these recommendations should not have been employed to restrict or prohibit permit to therapies, as treatment decisions might have varied due to the unique clinical situation and personal preferences of each patient. 

Source: acrjournals.onlinelibrary.wiley.com/doi/10.1002/art.43212