Therapies & trial tracker

What is used now. What is being tested next.

Compare treatment classes without confusing regulatory approval, guideline recommendations, promising early results, and biological plausibility.

Treatment landscape

Browse by evidence and approach

This is an educational map of treatment classes, not a ranked list or treatment recommendation.

Established careVerified 2026-07-10

Hydroxychloroquine is foundational therapy for most people with SLE when not contraindicated

Current major guidelines recommend hydroxychloroquine broadly in lupus, while dose, contraindications, interactions, and eye monitoring require individualized clinical care.

Evidence design: Guideline Or Regulatory
Directness: Clinical Outcome

Inspect the evidence

Technical interpretation

The 2025 ACR guideline recommends routine hydroxychloroquine treatment unless contraindicated; EULAR likewise places antimalarial therapy at the foundation of SLE management.

Evidence and provenance

SupportsAmerican College of Rheumatology SLE guideline (2025) (opens in a new tab)
Current U.S. guideline recommendation and implementation context.
SupportsFanouriakis et al., Annals of the Rheumatic Diseases (2024) (opens in a new tab)
Independent international recommendations support broad antimalarial use.

Limitations

A population-level recommendation is not an individual prescription
Dose and retinal screening require clinician oversight

Review state: Citation Audited · Record ID: care-hcq-foundational

Established careVerified 2026-07-10

Current treatment strategies seek to minimize long-term glucocorticoid exposure

Steroids can be essential for rapid control, but current guidelines emphasize reducing ongoing exposure because cumulative treatment can cause substantial harm.

Evidence design: Guideline Or Regulatory
Directness: Clinical Outcome

Inspect the evidence

Technical interpretation

ACR and EULAR recommendations prioritize the lowest feasible glucocorticoid exposure, with earlier use of steroid-sparing conventional or biologic therapy when needed to control disease.

Evidence and provenance

SupportsAmerican College of Rheumatology SLE guideline (2025) (opens in a new tab)
Recommends minimizing glucocorticoid exposure and earlier steroid-sparing treatment.
SupportsFanouriakis et al., Annals of the Rheumatic Diseases (2024) (opens in a new tab)
Provides an independent treat-to-target and tapering framework.

Limitations

Tapering must reflect disease severity and organ risk
Abrupt discontinuation can be dangerous

Review state: Citation Audited · Record ID: care-glucocorticoid-minimization

Established careVerified 2026-07-10

Lupus treatment depends on organ involvement, severity, reproductive context, comorbidities, and patient priorities

There is no single ranked treatment list for everyone with lupus. Kidney disease, pregnancy plans, infections, prior responses, access, and individual goals can change the safest option.

Evidence design: Guideline Or Regulatory
Directness: Clinical Outcome

Inspect the evidence

Technical interpretation

Contemporary systemic and kidney guidelines use organ- and context-specific treatment pathways and emphasize shared decision-making rather than diagnosis-wide ranking.

Evidence and provenance

SupportsAmerican College of Rheumatology SLE guideline (2025) (opens in a new tab)
Organ-specific recommendations and shared decision-making framework.
SupportsKDIGO, Kidney International (2024) (opens in a new tab)
Kidney-specific treatment and monitoring context.

Limitations

Guidelines cannot encode every clinical circumstance
Jurisdiction, access, age, pregnancy, and comorbidity evidence may differ

Review state: Citation Audited · Record ID: care-organ-context

Established careVerified 2026-07-10

The FDA label includes obinutuzumab for adults with active lupus nephritis receiving standard therapy

In the United States, obinutuzumab has a lupus-nephritis indication for adults receiving standard therapy. Approval does not mean it is appropriate for every person or approved the same way everywhere.

Evidence design: Guideline Or Regulatory
Directness: Clinical Outcome

Inspect the evidence

Technical interpretation

The October 2025 U.S. prescribing information added active lupus nephritis in adults receiving standard therapy to the labeled indications for obinutuzumab.

Evidence and provenance

SupportsU.S. FDA prescribing information (revised 2025) (opens in a new tab)
Primary U.S. label for indication, population, administration, warnings, and adverse reactions.

Limitations

U.S.-specific regulatory status
The label contains boxed warnings and important infection and monitoring considerations

Review state: Citation Audited · Record ID: care-obinutuzumab-us-ln

Structured frontier records

Investigational is not established care

These records make the uncertainty boundary explicit and link to the claim ledger rather than presenting a ranked pipeline.

Investigational

Autologous CD19 CAR-T

Small uncontrolled SLE cohorts report remission during limited follow-up; prospective programs are evaluating safety and clinical outcomes.

Not established: Comparative superiority; Cure; Long-term population-level safety; Use in routine or mild SLE.

Inspect source-linked claims

Hypothesis only

EBV-directed prevention or treatment

Epidemiologic association and a human mechanistic study support research, but there is no demonstrated lupus prevention or treatment effect.

Not established: Lupus prevention; Lupus treatment efficacy; Patient-selection biomarker; Dose or timing.

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Investigational

Microbiome-directed intervention

A small single-arm FMT pilot reported short-term SRI-4 responses. Controlled efficacy, durable benefit, and safety in SLE are not established.

Not established: Efficacy versus placebo; Validated organisms or donor profile; Safety after lymphodepletion; Combination benefit with CAR-T.

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Trial tracker

Registry records, not results

Statuses were verified on the dates shown. The update script routes any future registry change through editorial review before publication.

Selected registered CAR-T studies in systemic lupus erythematosus
Study	Intervention and population	Phase/design	Status	Enrollment	Last checked
KYSA-1 (NCT05938725) (opens in a new tab)	KYV-101 autologous fully human anti-CD19 CAR-T after lymphodepletion Adults with refractory class III or IV lupus nephritis	Phase 1/2 Open-label, non-randomized, sequential assignment	active not recruiting	6 actual	2026-07-10
YTB323 in severe refractory SLE (NCT05798117) (opens in a new tab)	YTB323 (rapcabtagene autoleucel) autologous anti-CD19 CAR-T People with severe, refractory SLE	Phase 1/2 Open-label, single-group assignment	active not recruiting	21 actual	2026-07-10
Breakfree-SLE (NCT07015983) (opens in a new tab)	CC-97540 / BMS-986353 / zola-cel autologous CD19 CAR-T after lymphodepletion People with active SLE, including lupus nephritis, despite glucocorticoids and at least two immunosuppressants	Phase 2 Multicenter, open-label, single-arm	recruiting	89 estimated	2026-07-10

Each registry record describes planned methods and operating status. It does not establish efficacy.