Cristiana Sieiro Santos: Key Takeaways from the 2025 EULAR Recommendations
Cristiana Sieiro Santos, Rheumatology Clinician at Manchester University NHS Foundation Trust, shared a post on LinkedIn about a paper by Antonis Fanouriakis et al. published in Annals of the Rheumatic Diseases:
“EULAR 2025 Recommendations for Systemic Lupus Erythematosus (SLE) with Kidney Involvement
A major update published in Annals of the Rheumatic Diseases (Fanouriakis et al., 2025) provides evidence-based and consensus-driven guidance for managing lupus nephritis, reflecting recent advances and new therapeutic options.
Key highlights
- Diagnosis and monitoring – Kidney biopsy remains essential. Aim for preserved/improved kidney function at 3 months, and proteinuria <700 mg/g at 12 months.
- Combination therapy – Early use of glucocorticoids (rapid taper), mycophenolate or low-dose IV cyclophosphamide combined with biologics (belimumab, obinutuzumab) or calcineurin inhibitors (voclosporin, tacrolimus).
- Steroid minimisation– ≤5 mg/day by 4–6 months, with the goal of
- Non-immune management– Incorporates RAAS blockade, SGLT2 inhibitors, cardiovascular and bone protection, and up-to-date vaccination strategies.
- Multidisciplinary care– Shared rheumatology–nephrology management and informed decision-making are central to improving long-term outcomes.
Pregnancy should be planned only after ≥6 months of inactive nephritis, with compatible medications and close multidisciplinary supervision.
Kidney replacement therapies, including pre-emptive transplantation, are recommended once extrarenal disease is controlled.”
Title: EULAR recommendations for the management of systemic lupus erythematosus with kidney involvement: 2025 update
Authors: Antonis Fanouriakis, Myrto Kostopoulou, Hans-Joachim Anders, Jeanette Andersen, Martin Aringer, Michael W. Beresford, Andrea Doria, Eleni Frangou, Richard Furie, Dafna D. Gladman, Frederic Houssiau, Alexandre Karras, Marios Kouloumas, Anastasia-Vasiliki Madenidou, Ana Malvar, Smaragdi Marinaki, Chi Chiu Mok, Gabriella Moroni, Ioannis Parodis, Simona Rednic, Cristiana Sieiro Santos, Carlo Alberto Scire, Josef S. Smolen, Farah Tamirou, Yoshiya Tanaka, Y. K. Onno Teng, Elisabet Welin, George Bertsias, Dimitrios T. Boumpa
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