How do you manage recurrent inflammatory pleural effusions in lupus pleuritis?

I'll stick to the immunomodulatory treatments and not discuss thoracentesis and pleurodesis for large and recurrent effusions. (These are rarely needed anyway, and I'd get the help of a pulmonologist).

There really are no large study, or evidence-based proven therapies for pleural effusions and pleuritis in SLE patients. It really is empiric and driven by case studies and experience. My treatment strategy is very similar to that of how I treat resistant pericarditis (but I do not use colchicine).

See my previous answer on lupus pericarditis treatment.