Update of EULAR recommendations for the treatment of systemic sclerosis. Issue 8 (9th November 2016)

• Record Type: Journal Article
• Authors: Kowal-Bielecka, Otylia; Fransen, Jaap; Avouac, Jerome; Becker, Mike; Kulak, Agnieszka; Allanore, Yannick; Distler, Oliver; Clements, Philip; Cutolo, Maurizio; Czirjak, Laszlo; Damjanov, Nemanja; del Galdo, Francesco; Denton, Christopher P; Distler, Jörg H W; Foeldvari, Ivan; Figelstone, Kim; Frerix, Marc; Furst, Daniel E; Guiducci, Serena; Hunzelmann, Nicolas; Khanna, Dinesh; Matucci-Cerinic, Marco; Herrick, Ariane L; van den Hoogen, Frank; van Laar, Jacob M; Riemekasten, Gabriela; Silver, Richard; Smith, Vanessa; Sulli, Alberto; Tarner, Ingo; Tyndall, Alan; Welling, Joep; Wigley, Frederic; Valentini, Gabriele; Walker, Ulrich A; Zulian, Francesco; Müller-Ladner, Ulf;
• Other Names: author non-byline.; Daikeler Thomas author non-byline.; Lanciano Elisabetta author non-byline.; Bečvář Radim author non-byline.; Tomcik Michal author non-byline.; Gińdzieńska-Sieśkiewicz Ewa author non-byline.; Cuomo Giovanna author non-byline.; Iudici Michele author non-byline.; Rednic Simona author non-byline.; Vlachoyiannopoulos Panayiotis G. author non-byline.; Caporali Roberto author non-byline.; Carreira Patricia E. author non-byline.; de Reumatología Servicio author non-byline.; Novak Srdan author non-byline.; Minier Tünde author non-byline.; Kucharz Eugene J. author non-byline.; Gabrielli Armando author non-byline.; Moroncini Gianluca author non-byline.; Airo' Paolo author non-byline.; Hesselstrand Roger author non-byline.; Martinovic Duska author non-byline.; Radić Mislav author non-byline.; Marasovic-Krstulovic Daniela author non-byline.; Braun-Moscovici Yolanda author non-byline.; Balbir-Gurman Alexandra author non-byline.; Monaco Andrea Lo author non-byline.; Caramaschi Paola author non-byline.; Morović-Vergles Jadranka author non-byline.; Čulo Melanie I. author non-byline.; Henes Jörg author non-byline.; Santamaria Vera Ortiz author non-byline.; Heitmann Stefan author non-byline.; Krasowska Dorota author non-byline.; Michalska-Jakubus Małgorzata author non-byline.; Seidel Matthias F. author non-byline.; Hasler Paul author non-byline.; Rheumatologie Klinik für author non-byline.; Silva José A. Pereira Da author non-byline.; Salvador Maria J. author non-byline.; Stamenkovic Bojana author non-byline.; Stankovic Aleksandra author non-byline.; Tikly Mohammed author non-byline.; Ananieva Lidia P. author non-byline.; Beretta Lorenzo author non-byline.; Szucs Gabriella author non-byline.; Szamosi Szilvia author non-byline.; Bujidos Carlos de la Puente author non-byline.; de Reumatología Servicio author non-byline.; Midtvedt Øyvind author non-byline.; Hoffmann-Vold Anna-Maria author non-byline.; Launay David author non-byline.; Hachulla Eric author non-byline.; Riccieri Valeria author non-byline.; Ionescu Ruxandra author non-byline.; Opris Daniela author non-byline.; Mihai Carina author non-byline.; Herrgott Ilka author non-byline.; Beyer Christian author non-byline.; Ingegnoli Francesca author non-byline.; von Mühlen Carlos Alberto author non-byline.; Alegre-Sancho Juan José author non-byline.; Beltrán-Catalán Emma author non-byline.; Aringer Martin author non-byline.; Fantana Julia author non-byline.; Leuchten Nicolai author non-byline.; Tausche Anne-Kathrin author non-byline.; De Langhe Ellen author non-byline.; Vanthuyne Marie author non-byline.; Anic Branimir author non-byline.; Barešić Marko author non-byline.; Mayer Miroslav author non-byline.; Üprus Maria author non-byline.; Otsa Kati author non-byline.; Yavuz Sule author non-byline.; Granel Brigitte author non-byline.; Azevedo Valderilio F. author non-byline.; Muller Carolina author non-byline.; Jimenez Sergio A author non-byline.; Popa Serghei author non-byline.; Agachi Svetlana author non-byline.; Zenone Thierry author non-byline.; Stebbings Simon author non-byline.; Dockerty Joanne author non-byline.; Vacca Alessandra author non-byline.; Schollum Joanna author non-byline.; Veale Douglas J. author non-byline.; Toloza Sergio author non-byline.; Xu Dong author non-byline.; Olas Jacek author non-byline.; Rosato Edoardo author non-byline.; Foti Rosario author non-byline.; Adler Sabine author non-byline.; Dan Diana author non-byline.; Wiesik-Szewczyk Ewa author non-byline.; Olesińska Marzena author non-byline.; Kayser Cristiane author non-byline.; Fathi Nihal author non-byline.; Lefebvre Paloma García de la Peña author non-byline.; Imbert Bernard author non-byline.;
• Is Part Of: Annals of the rheumatic diseases. Volume 76:Issue 8(2017)
• Page Start: 1327
• Page End: 1339
• Publication Date: 2016-11-09
• Subjects: Systemic Sclerosis -- Treatment -- Cyclophosphamide -- Methotrexate; Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2016-209909
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : 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.