EULAR recommendations for the non-pharmacological management of systemic lupus erythematosus and systemic sclerosis.

Autor:	Parodis I; Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden ioannis.parodis@ki.se.; Department of Gastroenterology, Dermatology and Rheumatology, Karolinska University Hospital, Stockholm, Sweden.; Department of Rheumatology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden., Girard-Guyonvarc'h C; Division of Rheumatology, Department of Medicine, University Hospital of Geneva, Geneve, Switzerland.; Faculty of Medicine, University of Geneva, Geneva, Switzerland., Arnaud L; Department of Rheumatology, Hôpitaux Universitaires de Strasbourg, Centre National de Référence (RESO), INSERM UMR-S 1109, Strasbourg, France., Distler O; Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland., Domján A; Department of Rheumatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary., Van den Ende CHM; Department of Research, Sint Maartenskliniek, Nijmegen, The Netherlands.; Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands., Fligelstone K; Federation of European Scleroderma Associations (FESCA), Brussels, Belgium., Kocher A; Institute of Nursing Science, Faculty of Medicine, University of Basel, Basel, Switzerland., Larosa M; Rheumatology Unit, Department of Medical Specialties, ASL3, Genoa, Italy., Lau M; Arthritis Action, London, UK., Mitropoulos A; Department of Nursing and Midwifery, College of Health Wellbeing and Life Science, Sheffield Hallam University, Sheffield, UK., Ndosi M; School of Health and Social Wellbeing, University of the West of England, Bristol, UK., Poole JL; Occupational Therapy Graduate Program, School of Medicine, University of New Mexico, Albuquerque, New Mexico, USA., Redmond A; Leeds Institute for Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK., Ritschl V; Section for Outcomes Research, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria.; Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria., Alexanderson H; Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.; Department of Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden., Sjöberg Y; Swedish Rheumatism Association, Stockholm, Sweden., von Perner G; Swedish Rheumatism Association, Stockholm, Sweden., Uhlig T; Center for Treatment of Rheumatic and Musculoskeletal Diseases, Diakonhjemmet Hospital, Oslo, Norway., Varju C; Department of Rheumatology and Immunology, Medical School of University of Pécs, Pécs, Hungary., Vriezekolk JE; Department of Research, Sint Maartenskliniek, Nijmegen, The Netherlands., Welin E; School of Health Sciences, Örebro University, Örebro, Sweden., Westhovens R; Skeletal Biology and Engineering Research Center, KU Leuven, Leuven, Belgium., Stamm TA; Section for Outcomes Research, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria.; Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria., Boström C; Department of Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden.; Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
Jazyk:	angličtina
Zdroj:	Annals of the rheumatic diseases [Ann Rheum Dis] 2024 May 15; Vol. 83 (6), pp. 720-729. Date of Electronic Publication: 2024 May 15.
DOI:	10.1136/ard-2023-224416
Abstrakt:	Objective: To develop evidence-based recommendations for the non-pharmacological management of systemic lupus erythematosus (SLE) and systemic sclerosis (SSc). Methods: A task force comprising 7 rheumatologists, 15 other healthcare professionals and 3 patients was established. Following a systematic literature review performed to inform the recommendations, statements were formulated, discussed during online meetings and graded based on risk of bias assessment, level of evidence (LoE) and strength of recommendation (SoR; scale A-D, A comprising consistent LoE 1 studies, D comprising LoE 4 or inconsistent studies), following the European Alliance of Associations for Rheumatology standard operating procedure. Level of agreement (LoA; scale 0-10, 0 denoting complete disagreement, 10 denoting complete agreement) was determined for each statement through online voting. Results: Four overarching principles and 12 recommendations were developed. These concerned common and disease-specific aspects of non-pharmacological management. SoR ranged from A to D. The mean LoA with the overarching principles and recommendations ranged from 8.4 to 9.7. Briefly, non-pharmacological management of SLE and SSc should be tailored, person-centred and participatory. It is not intended to preclude but rather complement pharmacotherapy. Patients should be offered education and support for physical exercise, smoking cessation and avoidance of cold exposure. Photoprotection and psychosocial interventions are important for SLE patients, while mouth and hand exercises are important in SSc. Conclusions: The recommendations will guide healthcare professionals and patients towards a holistic and personalised management of SLE and SSc. Research and educational agendas were developed to address needs towards a higher evidence level, enhancement of clinician-patient communication and improved outcomes. Competing Interests: Competing interests: IP has received research funding and/or honoraria from Amgen, AstraZeneca, Aurinia, Elli Lilly, Gilead, GlaxoSmithKline, Janssen, Novartis, Otsuka, and Roche. LA has received research funding and/or consultancies from Alexion, Alpine, Amgen, AstraZeneca, Abbvie, Biogen, BMS, Boehringer-Ingelheim, GlaxoSmithKline, Janssen-Cilag, Kezar, Elli Lilly and Company, Medac, Novartis, Pfizer, Roche-Chugaï, Sêmeia, and Union Chimique Belge (UCB). OD has/had consultancy relationship with and/or has received research funding from and/or has served as a speaker for 4P-Pharma, Abbvie, Acceleron, Alcimed, Amgen, AnaMar, Arxx, AstraZeneca, Baecon, Blade, Bayer, Boehringer Ingelheim, Corbus, CSL Behring, 4P Science, Galapagos, Glenmark, Horizon, Inventiva, Janssen, Kymera, Lupin, Medscape, Miltenyi Biotec, Mitsubishi Tanabe, MSD, Novartis, Prometheus, Redxpharma, Roivant, Sanofi, and Topadur. AK has/had consultancy relationship with and/or has received research funding from Boehringer Ingelheim, Pfizer, Swiss Nursing Science Foundation, Swiss League Against Rheumatism, and University of Basel. MN reports research grants from BMS, Vifor Pharma and Sanofi paid to his institution, speaking fees from CCIS The Conference Company and Eli Lilly, all outside the submitted work. JEV reports speaker fees from Eli Lilly, and Galapagos. RW has received honoraria from Galapagos, Celltrion, Gilead Sciences, and Union Chimique Belge (UCB). The other authors declare that they have no conflicts of interest. (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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