24 June 2026
Today we publish our updated guideline for the management of children, young people and adults with systemic lupus erythematosus (SLE).
This updated, evidence‑based guideline reflects major advances in lupus care since 2017. For the first time, it takes a whole life‑course approach, bringing together recommendations for children, young people and adults in one comprehensive framework.
The guideline includes 102 graded recommendations covering diagnosis, assessment, monitoring, non‑pharmacological and pharmacological management, organ‑specific care – including lupus nephritis – and how services should be delivered across the UK.
A life‑course approach that supports continuity of care
A defining feature of this update is the life‑course approach, designed to support seamless care from childhood through to adulthood.
Dr Eve Smith, consultant paediatric rheumatologist and member of the Guideline Working Group, said:
“About 20% of patients will develop lupus in childhood and not having specific guidance is a barrier to best practice. Children tend to have much more active disease, they have more damage, they have higher standardised mortality rates.
One of the highlights in the guideline for paediatricians is the explicit endorsement of treat-to-target in children with lupus, as well as the formal recognition of transition as being a really high-risk period – which is something that the whole community needs to manage properly.
Having consistent, joined‑up guidance from childhood through to adulthood supports better transition, more confident clinicians and, ultimately, better outcomes.”
Clinical leadership grounded in UK practice
Lupus care has evolved rapidly over the past decade, with new therapies, stronger evidence and a growing focus on coordinated, multidisciplinary care.
Professor Edward M Vital, Guideline Chair, said:
“We've had multiple new drugs that have been approved since the previous guideline was written in 2017. We also brought in a literature review for lupus nephritis and the whole life course aspect, which we thought was really relevant. There is also increasing recognition in the field of lupus that the outcome isn't just about choosing the right drug or making a certain diagnostic choice, it's also about the way services are delivered and the way care is provisioned by departments and hospitals, and we wanted to write about that aspect too.”
Developed with clinicians and people with lupus
The guideline was developed by a multidisciplinary Guideline Working Group, including paediatric and adult rheumatology professionals, nephrologists, dermatologists, nurses, pharmacists, allied health professionals, GPs, methodologists, and people with lived experience of lupus.
Md Yuzaiful Md Yusof, lead author and Co‑Chair of the Guideline Working Group, said:
“Because this is the first life-course guideline in SLE in the UK, our scope is broad, not just composing of the treatments, but also from the identification of suspected patients all the way through to the delivery of care.
We wanted to produce guidance that reflects real‑world UK practice and reduces variation in care. By taking a life‑course approach and bringing together evidence, clinical expertise and patient experience, we hope this guideline supports better outcomes for everyone living with lupus.”
The patient voice at the centre
People with lived experience, supported by Lupus UK, were closely involved throughout the guideline’s development.
Debbie Kinsey, Health Information, Policy and Research Manager at Lupus UK, said:
“People living with lupus of all ages can feel genuinely encouraged by the progress the updated guideline represents. Given the advances in understanding and available treatment since the last guideline, this update means people can feel reassured that their care is based on the most up-to-date evidence we have. People can also speak to their healthcare professional about the guideline to support informed shared decision making about treatment. We hope that the updated guideline will make a meaningful difference in supporting everyone to access high-quality, evidence-based care wherever they live in the UK.”
The Guideline Collection
To complement the launch of the updated SLE guideline we are pleased to be providing a new Guideline Collection, available on BSR e-learning, bringing together all guideline resources to support you with implementing the recommendations in practice.
Resources include:
- A new episode of the Talking Rheumatology podcast, hosted by Editor-in-Chief of Rheumatology, Prof Ernest Choy, interviewing key authors of the guideline
- A video version of the podcast episode (Rheumatology Roundtable)
- Easy-access summary sheet
- Lupus nephritis algorithm
- Audit tool to check how your services comply with the new recommendations
- Full guideline
- Executive summary
All BSR guidelines and guideline resources are published in Rheumatology under an ‘open access’ licence and available for free via the BSR website.