@article{discovery10198752, month = {January}, year = {2025}, note = {{\copyright} 2024 The Author(s). Published by Elsevier B.V. on behalf of European Alliance of Associations for Rheumatology (EULAR). This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).}, pages = {29--40}, title = {EULAR recommendations for the treatment of systemic sclerosis: 2023 update}, volume = {84}, journal = {Annals of the Rheumatic Diseases}, publisher = {BMJ}, author = {Del Galdo, Francesco and Lescoat, Alain and Conaghan, Philip G and Bertoldo, Eugenia and {\vC}oli{\'c}, Jelena and Santiago, T{\^a}nia and Suliman, Yossra A and Matucci-Cerinic, Marco and Gabrielli, Armando and Distler, Oliver and Hoffmann-Vold, Anna-Maria and Castellv{\'i}, Ivan and Balbir-Gurman, Alexandra and Vonk, Madelon and Ananyeva, Lidia and Rednic, Simona and Tarasova, Anna and Ostojic, Pedrag and Boyadzhieva, Vladimira and El Aoufy, Khadija and Farrington, Sue and Galetti, Ilaria and Denton, Christopher P and Kowal-Bielecka, Otylia and Mueller-Ladner, Ulf and Allanore, Yannick}, url = {https://doi.org/10.1136/ard-2024-226430}, abstract = {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.}, keywords = {Connective Tissue Diseases, Pulmonary Arterial Hypertension, Pulmonary Fibrosis, Scleroderma, Systemic, Therapeutics} }