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Objective: This international task force aimed to provide healthcare professionals and persons living with systemic lupus erythematosus (SLE) with consensus-based recommendations for physical activity and exercise in SLE., Methods: Based on evidence from a systematic literature review and expert opinion, 3 overarching principles and 15 recommendations were agreed on by Delphi consensus., Results: The overarching principles highlight the importance of shared decision-making and the need to explain the benefits of physical activity to persons living with SLE and other healthcare providers. The 15 specific recommendations state that physical activity is generally recommended for all people with SLE, but in some instances, a medical evaluation may be needed to rule out contraindications. Pertaining to outdoor activity, photoprotection is necessary. Both aerobic and resistance training programmes are recommended, with a gradual increase in frequency and intensity, which should be adapted for each individual, and ideally supervised by qualified professionals., Conclusion: In summary, the consensus reached by the international task force provides a valuable framework for the integration of physical activity and exercise into the management of SLE, offering a tailored evidence-based and eminence-based approach to enhance the well-being of individuals living with this challenging autoimmune condition., Competing Interests: Competing interests: SG, TG, SA, GB, TD, YF, HH, KH, DK-H, K-YS, AL, LL, SS and AS-M have no disclosures. AM has received funding for an investigator-initiated study from GlaxoSmithKline (Project ID 10743). IP has received honoraria from AstraZeneca, Boehringer Ingelheim, Lilly, Novartis and Pfizer. SZS has received grant funding from Pfizer and has consulted for GlaxoSmithKline, Aurinia Pharmaceuticals Inc, AstraZeneca, Lilly, LLC, Biogen and Cabaletta. MFU-G has received funding from Janssen and honoraria from AztraZeneca, Ferrer and GlaxoSmithKline. MYMY has received consultancy fees from Aurinia Pharmaceuticals and UCB and speaker fees from Alumis, Novartis and Roche. IP has received research funding and/or honoraria from Amgen, AstraZeneca, Aurinia, Elli Lilly, Gilead, GlaxoSmithKline, Janssen, Novartis, Otsuka and Roche. LA is a consultant for Alexion, Alpine, Amgen, AstraZeneca, AbbVie, Biogen, Bristol Myers Squibb, Boehringer Ingelheim, GSK, Grifols, Janssen, LFB, Lilly, Menarini France, Medac, Novartis, Pfizer, Roche-Chugaï, Sêmeia and UCB., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)