eprintid: 10198752 rev_number: 16 eprint_status: archive userid: 699 dir: disk0/10/19/87/52 datestamp: 2024-10-22 16:45:24 lastmod: 2025-02-10 11:23:06 status_changed: 2024-10-22 16:45:24 type: article metadata_visibility: show sword_depositor: 699 creators_name: Del Galdo, Francesco creators_name: Lescoat, Alain creators_name: Conaghan, Philip G creators_name: Bertoldo, Eugenia creators_name: Čolić, Jelena creators_name: Santiago, Tânia creators_name: Suliman, Yossra A creators_name: Matucci-Cerinic, Marco creators_name: Gabrielli, Armando creators_name: Distler, Oliver creators_name: Hoffmann-Vold, Anna-Maria creators_name: Castellví, Ivan creators_name: Balbir-Gurman, Alexandra creators_name: Vonk, Madelon creators_name: Ananyeva, Lidia creators_name: Rednic, Simona creators_name: Tarasova, Anna creators_name: Ostojic, Pedrag creators_name: Boyadzhieva, Vladimira creators_name: El Aoufy, Khadija creators_name: Farrington, Sue creators_name: Galetti, Ilaria creators_name: Denton, Christopher P creators_name: Kowal-Bielecka, Otylia creators_name: Mueller-Ladner, Ulf creators_name: Allanore, Yannick title: EULAR recommendations for the treatment of systemic sclerosis: 2023 update ispublished: pub divisions: UCL divisions: B02 divisions: C10 divisions: D17 divisions: G90 keywords: Connective Tissue Diseases, Pulmonary Arterial Hypertension, Pulmonary Fibrosis, Scleroderma, Systemic, Therapeutics note: © 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/). 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. date: 2025-01 date_type: published publisher: BMJ official_url: https://doi.org/10.1136/ard-2024-226430 oa_status: green full_text_type: pub language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 2327847 doi: 10.1136/ard-2024-226430 medium: Print-Electronic pii: ard-2024-226430 lyricists_name: Denton, Christopher lyricists_id: CPDEN87 actors_name: Denton, Christopher actors_id: CPDEN87 actors_role: owner funding_acknowledgements: EULAR recommendation grant QoC 010 [EULAR] full_text_status: public publication: Annals of the Rheumatic Diseases volume: 84 pagerange: 29-40 event_location: England citation: Del Galdo, Francesco; Lescoat, Alain; Conaghan, Philip G; Bertoldo, Eugenia; Čolić, Jelena; Santiago, Tânia; Suliman, Yossra A; ... Allanore, Yannick; + view all <#> Del Galdo, Francesco; Lescoat, Alain; Conaghan, Philip G; Bertoldo, Eugenia; Čolić, Jelena; Santiago, Tânia; Suliman, Yossra A; Matucci-Cerinic, Marco; Gabrielli, Armando; Distler, Oliver; Hoffmann-Vold, Anna-Maria; Castellví, Ivan; Balbir-Gurman, Alexandra; Vonk, Madelon; Ananyeva, Lidia; Rednic, Simona; Tarasova, Anna; Ostojic, Pedrag; Boyadzhieva, Vladimira; El Aoufy, Khadija; Farrington, Sue; Galetti, Ilaria; Denton, Christopher P; Kowal-Bielecka, Otylia; Mueller-Ladner, Ulf; Allanore, Yannick; - view fewer <#> (2025) EULAR recommendations for the treatment of systemic sclerosis: 2023 update. Annals of the Rheumatic Diseases , 84 pp. 29-40. 10.1136/ard-2024-226430 <https://doi.org/10.1136/ard-2024-226430>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10198752/7/Denton_EULAR%20recommendations%20for%20the%20treatment%20of%20systemic%20sclerosis_VoR.pdf