RT Journal Article
SR Electronic
T1 EULAR recommendations for the treatment of systemic sclerosis: a report from the EULAR Scleroderma Trials and Research group (EUSTAR)
JF Annals of the Rheumatic Diseases
JO Ann Rheum Dis
FD BMJ Publishing Group Ltd and European League Against Rheumatism
SP 620
OP 628
DO 10.1136/ard.2008.096677
VO 68
IS 5
A1 O Kowal-Bielecka
A1 R Landewé
A1 J Avouac
A1 S Chwiesko
A1 I Miniati
A1 L Czirjak
A1 P Clements
A1 C Denton
A1 D Farge
A1 K Fligelstone
A1 I Földvari
A1 D E Furst
A1 U Müller-Ladner
A1 J Seibold
A1 R M Silver
A1 K Takehara
A1 B Garay Toth
A1 A Tyndall
A1 G Valentini
A1 F van den Hoogen
A1 F Wigley
A1 F Zulian
A1 Marco Matucci-Cerinic
A1 and the EUSTAR co-authors
YR 2009
UL http://ard.bmj.com/content/68/5/620.abstract
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.