• Johanna Mucke and Matthias Schneider.
• Poliklinik für Rheumatologie, Heinrich-Heine-Universität Düsseldorf.
• Dtsch. Med. Wochenschr. 2020 Aug 1; 145 (16): 1179-1183.

AbstractThe publication of the new ACR/EULAR classification criteria for systemic lupus erythematosus (SLE) and the revision of the EULAR recommendations for the management of SLE last year include many important novelties that will change the classification and care of lupus patients. This refers to both general basic treatment principles and specific therapy recommendations. For example, SLE can only be classified as such if antinuclear antibodies (ANA) are present, independently of titer height and fluorescence pattern. If ANAs are detected, lupus-specific symptoms and serological abnormalities are assessed and separately scored. A score of 10 and more classifies an SLE patient as such. With regard to the care of SLE patients, every therapeutic decision should follow a treat-to-target approach with the aim of achieving remission. Aim is to ensure long-term survival, reduce damage and improve quality of life. These goals are achieved by early diagnosis, consistent therapy and regular evaluation of disease activity. All patients should receive antimalarials in the absence of contraindications. If the response is inadequate or in case of moderate to severe organ manifestations, steroid pulses over a few days and the early use of immunosuppressive drugs (IM) are recommended. With the inclusion of biologicals, especially belimumab and rituximab, new substance classes made their way into the recommendations.© Georg Thieme Verlag KG Stuttgart · New York.

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