| Autor: |
Cristiane Kayser, Sandra Maximiano de Oliveira Delgado, Adriana Fontes Zimmermann, Alex Magno Coelho Horimoto, Ana Paula Toledo Del Rio, Carolina de Souza Müller, Cintia Zumstein Camargo, Cristiano Michelini Lupo, Daniela Aparecida de Moraes, Eduardo José Do Rosário E Souza, Flávia Patrícia Sena Teixeira Santos, Juliana Yuri Sekiyama, Lilian Scussel Lonzetti, Lucas Victória de Oliveira Martins, Mailze Campos Bezerra, Markus Bredemeier, Maria Carolina Oliveira, Maria Cecília da Fonseca Salgado, Renata Miossi, Sheila Márcia de Araújo Fontenele, Vanessa Hax, Andrea Tavares Dantas, Percival Degrava Sampaio-Barros |
| Jazyk: |
angličtina |
| Rok vydání: |
2024 |
| Předmět: |
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| Zdroj: |
Advances in Rheumatology, Vol 64, Iss 1, Pp 1-16 (2024) |
| Druh dokumentu: |
article |
| ISSN: |
2523-3106 |
| DOI: |
10.1186/s42358-024-00392-w |
| Popis: |
Abstract Background Systemic sclerosis (SSc) is a rare chronic autoimmune disease with heterogeneous manifestations. In the last decade, several clinical trials have been conducted to evaluate new treatment options for SSc. The purpose of this work is to update the recommendations of the Brazilian Society of Rheumatology in light of the new evidence available for the pharmacological management of SSc. Methods A systematic review including randomized clinical trials (RCTs) for predefined questions that were elaborated according to the Patient/Population, Intervention, Comparison, and Outcomes (PICO) strategy was conducted. The rating of the available evidence was performed according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. To become a recommendation, at least 75% agreement of the voting panel was needed. Results Six recommendations were elaborated regarding the pharmacological treatment of Raynaud’s phenomenon, the treatment (healing) and prevention of digital ulcers, skin involvement, interstitial lung disease (ILD) and gastrointestinal involvement in SSc patients based on results available from RCTs. New drugs, such as rituximab, were included as therapeutic options for skin involvement, and rituximab, tocilizumab and nintedanib were included as therapeutic options for ILD. Recommendations for the pharmacological treatment of scleroderma renal crisis and musculoskeletal involvement were elaborated based on the expert opinion of the voting panel, as no placebo-controlled RCTs were found. Conclusion These guidelines updated and incorporated new treatment options for the management of SSc based on evidence from the literature and expert opinion regarding SSc, providing support for decision-making in clinical practice. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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