Ερευνητικό υλικό ΕΚΠΑ

Update of EULAR recommendations for the treatment of systemic sclerosis

Αγγλικά

The aim was to update the 2009 European League against Rheumatism (EULAR) recommendations for the treatment of systemic sclerosis (SSc), with attention to new therapeutic questions. Update of the previous treatment recommendations was performed according to EULAR standard operating procedures. The task force consisted of 32 SSc clinical experts from Europe and the USA, 2 patients nominated by the pan-European patient association for SSc (Federation of European Scleroderma Associations (FESCA)), a clinical epidemiologist and 2 research fellows. All centres from the EULAR Scleroderma Trials and Research group were invited to submit and select clinical questions concerning SSc treatment using a Delphi approach. Accordingly, 46 clinical questions addressing 26 different interventions were selected for systematic literature review. The new recommendations were based on the available evidence and developed in a consensus meeting with clinical experts and patients. The procedure resulted in 16 recommendations being developed (instead of 14 in 2009) that address treatment of several SSc-related organ complications: Raynaud's phenomenon (RP), digital ulcers (DUs), pulmonary arterial hypertension (PAH), skin and lung disease, scleroderma renal crisis and gastrointestinal involvement. Compared with the 2009 recommendations, the 2016 recommendations include phosphodiesterase type 5 (PDE-5) inhibitors for the treatment of SSc-related RP and DUs, riociguat, new aspects for endothelin receptor antagonists, prostacyclin analogues and PDE-5 inhibitors for SSc-related PAH. New recommendations regarding the use of fluoxetine for SSc-related RP and haematopoietic stem cell transplantation for selected patients with rapidly progressive SSc were also added. In addition, several comments regarding other treatments addressed in clinical questions and suggestions for the SSc research agenda were formulated. These updated data-derived and consensus-derived recommendations will help rheumatologists to manage patients with SSc in an evidence-based way. These recommendations also give directions for future clinical research in SSc. © Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

2017

Kowal-Bielecka, O.
Fransen, J.
Avouac, J.
Becker, M.
Kulak, A.
Allanore, Y.
Distler, O.
Clements, P.
Cutolo, M.
Czirjak, L.
Damjanov, N.
Del Galdo, F.
Denton, C.P.
Distler, J.H.W.
Foeldvari, I.
Figelstone, K.
Frerix, M.
Furst, D.E.
Guiducci, S.
Hunzelmann, N.
Khanna, D.
Matucci-Cerinic, M.
Herrick, A.L.
Van Den Hoogen, F.
Van Laar, J.M.
Riemekasten, G.
Silver, R.
Smith, V.
Sulli, A.
Tarner, I.
Tyndall, A.
Welling, J.
Wigley, F.
Valentini, G.
Walker, U.A.
Zulian, F.
Müller-Ladner, U.
EUSTAR Coauthors
Daikeler, T.
Lanciano, E.
Becvár, R.
Tomcik, M.
Gińdzieńska-Sieskiewicz, E.
Cuomo, G.
Iudici, M.
Rednic, S.
Vlachoyiannopoulos, P.G.
Caporali, R.
Carreira, P.E.
Novak, S.
Minier, T.
Kucharz, E.J.
Gabrielli, A.
Moroncini, G.
Airo', P.
Hesselstrand, R.
Martinovic, D.
Radic, M.
Marasovic-Krstulovic, D.
Braun-Moscovici, Y.
Balbir-Gurman, A.
Lo Monaco, A.
Caramaschi, P.
Morovic-Vergles, J.
Henes, J.
Ortiz Santamaria, V.
Heitmann, S.
Krasowska, D.
Seidel, M.F.
Hasler, P.
Pereira Da Silva, J.A.
Salvador, M.J.
Stamenkovic, B.
Stankovic, A.
Tikly, M.
Ananieva, L.P.
Beretta, L.
Szucs, G.
Szamosi, S.
de la Puente Bujidos, C.
Midtvedt, Ø.
Hoffmann-Vold, A.-M.
Launay, D.
Hachulla, E.
Riccieri, V.
Ionescu, R.
Opris, D.
Mihai, C.
Herrgott, I.
Beyer, C.
Ingegnoli, F.
von Mühlen, C.A.
Alegre-Sancho, J.J.
Beltrán-Catalán, E.
Aringer, M.
Fantana, J.
Leuchten, N.
Tausche, A.-K.
De Langhe, E.
Vanthuyne, M.
Anic, B.
Barešic, M.
Mayer, M.
Üprus, M.
Otsa, K.
Yavuz, S.
Granel, B.
Azevedo, V.F.
Muller, C.
Jimenez, S.A.
Popa, S.
Agachi, S.
Zenone, T.
Stebbings, S.
Dockerty, J.
Vacca, A.
Schollum, J.
Veale, D.J.
Toloza, S.
Xu, D.
Olas, J.
Rosato, E.
Foti, R.
Adler, S.
Dan, D.
Wiesik-Szewczyk, E.
Olesińska, M.
Kayser, C.
Fathi, N.
de la Peña Lefebvre, P.G.
Imbert, B.

Annals of the Rheumatic Diseases

BMJ Publishing Group

76

8

1327-1339

ambrisentan; bosentan; cyclophosphamide; dipeptidyl carboxypeptidase inhibitor; fluoxetine; glucocorticoid; iloprost; macitentan; methotrexate; nifedipine; phosphodiesterase V inhibitor; prokinetic agent; prostacyclin; proton pump inhibitor; riociguat; sildenafil; tadalafil; treprostinil; dipeptidyl carboxypeptidase inhibitor; endothelin receptor antagonist; fluoxetine; glucocorticoid; phosphodiesterase V inhibitor; prostacyclin derivative; pyrazole derivative; pyrimidine derivative; riociguat; serotonin uptake inhibitor, Article; clinical research; disease severity; evidence based practice; finger ulcer; gastrointestinal disease; human; kidney disease; lung disease; meta analysis (topic); multicenter study (topic); phase 2 clinical trial (topic); priority journal; pulmonary hypertension; randomized controlled trial (topic); Raynaud phenomenon; skin disease; systematic review (topic); systemic sclerosis; complication; consensus development; Delphi study; Europe; finger; Gastrointestinal Diseases; hematopoietic stem cell transplantation; Hypertension, Pulmonary; Kidney Diseases; Lung Diseases; practice guideline; Raynaud Disease; rheumatology; Scleroderma, Systemic; ulcer, Angiotensin-Converting Enzyme Inhibitors; Delphi Technique; Endothelin Receptor Antagonists; Europe; Fingers; Fluoxetine; Gastrointestinal Diseases; Glucocorticoids; Hematopoietic Stem Cell Transplantation; Humans; Hypertension, Pulmonary; Kidney Diseases; Lung Diseases; Phosphodiesterase 5 Inhibitors; Prostaglandins I; Pyrazoles; Pyrimidines; Raynaud Disease; Rheumatology; Scleroderma, Systemic; Serotonin Uptake Inhibitors; Ulcer

https://doi.org/10.1136/annrheumdis-2016-209909

10.1136/annrheumdis-2016-209909

https://pergamos.lib.uoa.gr/uoa/dl/object/3001043