The first UK guidance on the care of adults with systemic lupus erythematosus (lupus) has been published by the British Society of Rheumatology.

The clinical guideline is accredited by the NICE and covers diagnosis, assessment, monitoring and treatment of patients with mild, moderate and severe lupus. Aimed at rheumatologists and clinical nurse specialists in lupus, nephrologists, immunologists, dermatologists, emergency medicine practitioners, GPs and many trainees will also find the guidance useful. 

Lupus can affect any part of the body and may be difficult to diagnose and treat. It has a major impact on the health and activities of patients and is associated with a significant risk of dying prematurely, as it reduces average lifespan by about 25 years. Lupus is also more common than many realise, affecting nearly 1 in 1000 people in the UK. 

The guideline’s recommendations address care of patients with common symptoms such as skin rashes and arthritis as well as those with less common but potentially more serious problems like kidney disease.

It covers routine monitoring and treatments that may reduce steroid use and second line approaches if there is a poor response to first choice treatment. It also promotes the referral of patients with the most serious and difficult-to-control disease to specialised lupus centres with experience of new therapies and with multi-disciplinary team backup.

Caroline Gordon, lupus expert, Professor of Rheumatology and lead guideline author comments: “Once my colleagues in the UK implement this guideline, I would expect that patients will experience measurable improvements in care as a result of earlier diagnosis and more appropriate treatment; they can expect more rapid resolution of symptoms, reduction in disease flares and improvements in their quality of life, with fewer long term complications of the disease and its treatment – and, ultimately, improved survival.”

Elizabeth MacPhie, Consultant Rheumatologist and Chair of the British Society for Rheumatology’s Standards, Audit and Guidelines Working Group said: “Our guidelines are key to good care in rheumatological conditions. They firmly link the evidence base to clinical practice to help health professionals deliver the right care at the right time to the right patients – which might sound simple but can be a real challenge in a relapsing and remitting condition such as lupus.”

The guideline was published in the Rheumatology Journal and is available at