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SLE is a disease of waxing and waning activity and progressive organ damage; a critical goal in the
management of SLE is to reduce organ damage accrual1

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SLE is ~9x more prevalent in females than males2, and disproportionally affects racial/ethnic minority groups who have earlier onset of severe manifestations of SLE, such as LN3

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experience organ damage within 5 years of diagnosis4-7

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~20% of patients with LN will progress to ESKD within
10 years of diagnosis9

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Disease modification framework:

Reducing disease activity with the fewest treatment-associated toxicities and slowing or preventing irreversible organ damage10

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SLE management goals11,12:

Consider applying a disease modification mindset with shared decision-making to improve patient outcomes

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    Abbreviations

    ESKD = end-stage kidney disease; LN = lupus nephritis; SLE = systemic lupus erythematosus; US = United States.

    References

    1. Thanou A, et al. J Autoimmun. 2021;119:102615.
    2. Izmirly PM, et al. Arthritis Rheumatol. 2021;73(6):991-996.
    3. Maningding E, et al. Arthritis Care Res (Hoboken). 2020;72(5):622-629.
    4. Chambers SA, et al. Rheumatology (Oxford). 2009;48(6):673-675.
    5. Urowitz MB, et al. Arthritis Care Res (Hoboken). 2012;64(1):132-137.
    6. Frodlund M, et al. Lupus. 2019;28(10):1261-1272.
    7. Segura BT, et al. Rheumatology (Oxford). 2020;59(3):698.
    8. Morales E, et al. Nephron. 2021;145(1):1-13.
    9. Tektonidou MG, et al. Arthritis Rheumatol. 2016;68(6):1432-1441.
    10. van Vollenhoven R, et al. Lupus Sci Med. 2022;9(1):e000634.
    11. American College of Rheumatology. 2025 American College of Rheumatology Guideline for the Treatment of Systemic Lupus Erythematosus (SLE): Guideline Summary. May 7, 2025. Accessed September 12, 2025. https://assets.contentstack.io/v3/assets/bltee37abb6b278ab2c/bltec93920aad624e33/sle-guideline-summary-2025.pdf
    12. Sammaritano LR, et al. Arthritis Rheumatol. 2025;77(9):1115-1135.