关键词: 系统性红斑狼疮, 指南, 解读

Abstract:

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by diverse clinical manifestations, high heterogeneity, and strongly individualized treatment approaches. In 2021, the global incidence of SLE was (1.5-11.0)/100 000 person-years, while in Europe, the incidence was (1.5-7.4)/100 000 person-years. From 2009 to 2016, the incidence of SLE in the United States reached as high as 49/100 000 person-years. From 2013 to 2017 in China, analysis of the national medical insurance database and the National Rheumatology Data Center showed that the incidence of SLE in China was 14.09/100 000 person-years. Data from different countries indicate significant regional differences in the SLE incidence. With the continuous development of new diagnostic concepts and therapeutic drugs, significant progress has been made in SLE treatment strategies. However, problems such as non-standardized diagnosis and insufficient long-term management remain in the diagnosis and treatment practice of SLE in China. The "Chinese Guidelines for the Diagnosis and Treatment of Systemic Lupus Erythematosus (2025 Edition)" addresses 12 clinically relevant issues. Based on the latest domestic and international research evidence and China's SLE diagnosis and treatment practice, the guidelines provide evidence-based recommendations tailored to China's national context. These guidelines play a crucial role in promoting the advancement of standardized diagnosis and treatment and in improving the long-term prognosis of SLE patients in China. Compared with the "2020 Chinese Guidelines for the Diagnosis and Treatment of Systemic Lupus Erythematosus", the "2025 Edition" has been updated in terms of treatment targets, hormone maintenance doses, management of common organ involvement, therapeutic role of biological therapy, new immunosuppressants, and new treatment methods. This study focuses on interpreting the core recommendations of the guidelines, including SLE treatment targets, disease assessment methods, application of therapeutic drugs (including glucocorticoids, conventional immunosuppressants, and biologics), stratified treatment strategies for common organ involvement (including lupus nephritis, SLE with severe thrombocytopenia, SLE with antiphospholipid syndrome, and neuropsychiatric lupus), and long-term disease management. It aims to help clinicians quickly grasp the latest advances in SLE diagnosis and treatment, promote the implementation of standardized and individualized diagnosis and treatment concepts in clinical practice, and ultimately improve the overall diagnosis and treatment level, quality of life, and long-term survival rate of SLE patients in China.

Key words: Systemic lupus erythematosus, Guidelines, Interpretation