EULAR recommendations for the treatment of systemic sclerosis: 2023 update
Por:
Del Galdo, F, Lescoat, A, Conaghan, PG, Bertoldo, E, Colic, J, Santiago, T, Suliman, YA, Matucci-Cerinic, M, Gabrielli, A, Distler, O, Hoffmann-Vold, AM, Castellví, I, Balbir-Gurman, A, Vonk, M, Ananyeva, L, Rednic, S, Tarasova, A, Ostojic, P, Boyadzhieva, V, El Aoufy, K, Farrington, S, Galetti, I, Denton, CP, Kowal-Bielecka, O, Mueller-Ladner, U, Allanore, Y
Publicada:
1 ene 2025
Ahead of Print:
1 oct 2024
Resumen:
Objectives: To update the 2017 European Alliance of Associations for Rheumatology (EULAR) recommendations for treatment of systemic sclerosis (SSc), incorporating new evidence and therapies. Methods: An international task force was convened in line with EULAR standard operating procedures. A nominal group technique exercise was performed in two rounds to define questions underpinning a subsequent systematic literature review. The evidence derived was discussed and overarching principles, recommendations and future research agenda were iteratively developed with voting rounds. Results: The task force agreed on 22 recommendations covering 8 clinical/organ domains including Raynaud's phenomenon, digital ulcers, pulmonary arterial hypertension, scleroderma renal crisis, skin fibrosis, interstitial lung disease (ILD), gastrointestinal manifestations and arthritis. Most new recommendations are related to skin fibrosis and ILD. These included novel recommendations for the use of mycophenolate mofetil, nintedanib, rituximab and tocilizumab for the treatment of these crucial disease manifestations. The recommendations also included first-line and second-line interventions, providing increased utility for rheumatology practitioners. Important additions to the future research agenda included consideration of novel interventions for the management of vascular, musculoskeletal and gastrointestinal manifestations and calcinosis, as well as for the local management of digital ulcers. Conclusion: These updated recommendations include the first set of synthetic and biological targeted therapies recommended for key fibrotic manifestations of SSc as well as first-line combination treatment for newly diagnosed pulmonary artery hypertension and prioritise a new research agenda for the coming years.
Filiaciones:
Del Galdo, F:
LIRMM, Leeds Inst Rheumat & Musculoskeletal Med, Leeds, England
Leeds Teaching Hosp Trust, NIHR Leeds Biomed Res Ctr, Leeds, England
Lescoat, A:
Rennes Univ Hosp, Dept Internal Med & Clin Immunol, Rennes, France
Conaghan, PG:
LIRMM, Leeds Inst Rheumat & Musculoskeletal Med, Leeds, England
Leeds Teaching Hosp Trust, NIHR Leeds Biomed Res Ctr, Leeds, England
Bertoldo, E:
Univ Verona, Dept Med, Rheumatol Unit, Verona, Italy
Colic, J:
Univ Belgrade, Fac Med, Rheumatol, Beograd, Serbia
Santiago, T:
Ctr Hosp & Univ Coimbra EPE, Rheumatol Dept, Coimbra, Portugal
Suliman, YA:
Assiut Univ, Fac Med, Dept Rheumatol & Rehabil, Assiut, Egypt
Matucci-Cerinic, M:
IRCCS San Raffaele Hosp, Unit Immunol Rheumatol Allergy & Rare Dis UnIRAR, Milan, Italy
IRCCS San Raffaele Hosp, Inflammat Fibrosis & Ageing Initiat INFLAGE, Milan, Italy
Gabrielli, A:
Univ Politecn Marche, Fac Med & Chirurg, Sci Clin & Molecolari, Ancona, Italy
Distler, O:
Univ Hosp Zurich, Ctr Expt Rheumatol, Zurich, Switzerland
Hoffmann-Vold, AM:
Oslo Univ Hosp, Oslo, Norway
Castellví, I:
Hosp Santa Creu & Sant Pau, Rheumatol, Barcelona, Spain
Balbir-Gurman, A:
Rambam Hlth Care Campus, B Shine Dept Rheumatol, Dept Internal Med B, Haifa, Israel
Vonk, M:
Radboud Univ Nijmegen, Dept Rheumat Dis, Nijmegen, Netherlands
Ananyeva, L:
Russian Acad Med Sci, Inst Rheumatol, Moscow, Russia
Rednic, S:
UMF Iuliu Hatieganu Cluj Napoca, Clin Reumatol, Cluj Napoca, Cluj, Romania
Tarasova, A:
Nasonova Res Inst Rheumatol RAMS, Moscow, Russia
Ostojic, P:
Univ Belgrade, Fac Med, Inst Rheumatol, Belgrade, Serbia
Boyadzhieva, V:
Med Univ Sofia, Dept Rheumatol, Sofia, Bulgaria
El Aoufy, K:
Univ Florence, Fac Med & Surg, Dept Clin & Expt Med, Florence, Italy
Farrington, S:
Scleroderma & Raynauds UK, London, England
Federat European Scleroderma Assoc, Milan, Italy
Galetti, I:
Federat European Scleroderma Assoc, Milan, Italy
Denton, CP:
UCL, Royal Free Hosp, Ctr Rheumatol, London, England
Kowal-Bielecka, O:
Med Univ Bialystok, Dept Rheumatol & Internal Med, Bialystok, Poland
Mueller-Ladner, U:
Univ Giessen, Rheumatol & Clin Immunol, Giessen, Germany
Allanore, Y:
Univ Paris Cite, Dept Rheumatol, UFR Med, Paris, France
Green Submitted, hybrid
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