As the proportion of individuals over 50 years of age and beyond increases, clinicians are being confronted by a number of patients within this age group with complex rheumatologic conditions, systemic lupus erythematosus being one of them. Although usually regarded as a milder disease, patients with late-onset lupus tend to have a worse long-term prognosis in terms of morbidity and mortality than those with younger-onset disease. Specific management strategies have not been studied in this patient group. Although most pharmacological interventions may be suitable for these patients, they should be tailored not only to the clinical manifestations present, but also to concomitant morbid conditions and to drug safety profiles. Further research in this area is warranted if our aim is to achieve the best possible long-term outcome for this patient group. © 2010 Future Medicine Ltd.