Lupus

While clinical comorbidities such as lupus nephritis, hypertension, and thrombocytopenia have traditionally dominated risk assessments, new findings presented at EULAR 2025 spotlight the critical—and often underrecognized—role of social determinants of health (SDOH) in shaping maternal outcomes.

Women with antiphospholipid syndrome and lupus anti-coagulant are at high risk of developing adverse pregnancy outcomes (APO). Usual care includes low molecular weight heparin (LMWH) and low dose aspirin (LDA). Despite these therapies, APO have been reported up to 40%. An important question is whether add-on immunosuppressive therapy could improve APO.

At the 2025 EULAR congress in Barcelona, Prof Dimitrios Boumpas presented a summary of the updated EULAR recommendations on the management of lupus nephritis (LN). The most significant change in the treatment paradigm of LN is that the historic standard of care (SOC) (i.e. mycophenolate with glucocorticoids, GC) is now known to be inferior to several licensed combinations, as well as other unlicensed combination therapies.

Social determinants of health (SDH), such as socioeconomic status and educational background are factors that are increasingly recognised as critical contributors to health outcomes in chronic diseases. Understanding how certain factors impact different RMDs is important, and new research into this for both systemic lupus erythematosus (SLE) and inflammatory arthritis was presented at the 2025 annual EULAR congress in Barcelona.

Connective tissue diseases (CTDs) and interstitial lung disease (ILD) represent a challenging intersection of systemic autoimmunity and progressive respiratory impairment. Research presented at EULAR 2025 continues to highlight the importance of CTD-ILD and the evolving landscape of therapeutic options for patients with autoimmune ILDs.

The race is on for the first chimeric antigen receptor (CAR)-based therapy to be approved for the treatment of systemic lupus erythematosus. Its main principle is to induce deep B-cell depletion, with the hope to reset the B-cell aberrant immunity for a sustained clinical remission. At EULAR 2025 in Barcelona, several advances of CAR-based therapies will be presented.