Today's sweep found a biosimilar filing but no new rheumatology drug action with clinical detail. The substantive publication addresses a gap that guidelines structurally create: lupus guidance concentrates on common major organ involvement, leaving the rare manifestations — the ones where a clinician most needs help — largely uncovered.
An international taskforce drawn from the European Reference Network on Connective Tissue and Musculoskeletal Diseases, the Systemic Lupus International Collaborating Clinics group and the European Lupus Society had previously produced consensus strategies for 24 rare manifestations. This adds 22 more, developed with 77 participants: diffuse pulmonary haemorrhage; rare cutaneous forms including bullous, chilblain and tumidus lupus and toxic epidermal necrolysis-like disease; interstitial nephritis and lupus podocytopathy; chorea, small fibre neuropathy, catatonia and intracranial hypertension; protein-losing enteropathy, lupus hepatitis, intestinal pseudo-obstruction and peritonitis; myositis and Jaccoud's arthropathy; and uveitis, angioedema from anti-C1 esterase inhibitor antibodies, interstitial cystitis and lupus mastitis.
These are expert-based strategies rather than evidence-based recommendations, and the taskforce says so — they exist precisely where trial evidence is insufficient and always will be, because these presentations are too rare to randomise. That makes the document worth knowing about before you meet one of them, since it is the only structured guidance that exists.
- No new rheumatology drug action with clinical detail today
- 22 additional rare SLE manifestations covered, on top of 24 previously
- Includes lupus podocytopathy, catatonia, protein-losing enteropathy, lupus mastitis
- Expert consensus by necessity — these presentations cannot be randomised
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