The use of ACTH preparations in SLE is supported by over 60 years of clinical experience,12 and a more recent open-label, single-arm case series involving 10 patients with chronic moderate-to-severe SLE, in which RCI resulted in significant improvements in SLE Disease Activity Index-2000 (SLEDAI-2K) scores and other measures of disease activity.13 Here, we report findings from a pilot 8-week, prospective, randomised, placebo-controlled study evaluating the efficacy and safety of RCI in patients with persistently active SLE despite moderate-dose corticosteroids. Here, POMC is linked to systemic lupus erythematosus.