PT - JOURNAL ARTICLE AU - O Kowal-Bielecka AU - R Landewé AU - J Avouac AU - S Chwiesko AU - I Miniati AU - L Czirjak AU - P Clements AU - C Denton AU - D Farge AU - K Fligelstone AU - I Földvari AU - D E Furst AU - U Müller-Ladner AU - J Seibold AU - R M Silver AU - K Takehara AU - B Garay Toth AU - A Tyndall AU - G Valentini AU - F van den Hoogen AU - F Wigley AU - F Zulian AU - Marco Matucci-Cerinic AU - and the EUSTAR co-authors TI - EULAR recommendations for the treatment of systemic sclerosis: a report from the EULAR Scleroderma Trials and Research group (EUSTAR) AID - 10.1136/ard.2008.096677 DP - 2009 May 01 TA - Annals of the Rheumatic Diseases PG - 620--628 VI - 68 IP - 5 4099 - http://ard.bmj.com/content/68/5/620.short 4100 - http://ard.bmj.com/content/68/5/620.full SO - Ann Rheum Dis2009 May 01; 68 AB - Purpose: The optimal treatment of systemic sclerosis (SSc) is a challenge because the pathogenesis of SSc is unclear and it is an uncommon and clinically heterogeneous disease affecting multiple organ systems. The aim of the European League Against Rheumatism (EULAR) Scleroderma Trials and Research group (EUSTAR) was to develop evidence-based, consensus-derived recommendations for the treatment of SSc.Methods: To obtain and maintain a high level of intrinsic quality and comparability of this approach, EULAR standard operating procedures were followed. The task force comprised 18 SSc experts from Europe, the USA and Japan, two SSc patients and three fellows for literature research. The preliminary set of research questions concerning SSc treatment was provided by 74 EUSTAR centres.Results: Based on discussion of the clinical research evidence from published literature, and combining this with current expert opinion and clinical experience, 14 recommendations for the treatment of SSc were formulated. The final set includes the following recommendations: three on SSc-related digital vasculopathy (Raynaud’s phenomenon and ulcers); four on SSc-related pulmonary arterial hypertension; three on SSc-related gastrointestinal involvement; two on scleroderma renal crisis; one on SSc-related interstitial lung disease and one on skin involvement. Experts also formulated several questions for a future research agenda.Conclusions: Evidence-based, consensus-derived recommendations are useful for rheumatologists to help guide treatment for patients with SSc. These recommendations may also help to define directions for future clinical research in SSc.