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

PARODIS, Ioannis, GIRARD-GUYONVARC’H, Charlotte, ARNAUD, Laurent, DISTLER, Oliver, DOMJÁN, Andrea, VAN DEN ENDE, Cornelia H.M., FLIGELSTONE, Kim, KOCHER, Agnes, LAROSA, Maddalena, LAU, Martin, MITROPOULOS, Alexandros, NDOSI, Mwidimi, POOLE, Janet L., REDMOND, Anthony, RITSCHL, Valentin, ALEXANDERSON, Helene, SJÖBERG, Yvonne, VON PERNER, Gunilla, UHLIG, Till, VARJU, Cecilia, VRIEZEKOLK, Johanna E., WELIN, Elisabet, WESTHOVENS, René, STAMM, Tanja A. and BOSTRÖM, Carina (2023). EULAR recommendations for the non-pharmacological management of systemic lupus erythematosus and systemic sclerosis. Annals of the Rheumatic Diseases.

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Abstract

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.

Item Type:	Article
Uncontrolled Keywords:	1103 Clinical Sciences; 1107 Immunology; 1117 Public Health and Health Services; Arthritis & Rheumatology; 3202 Clinical sciences; 3204 Immunology
Identification Number:	https://doi.org/10.1136/ard-2023-224416
SWORD Depositor:	Symplectic Elements
Depositing User:	Symplectic Elements
Date Deposited:	02 Oct 2023 15:46
Last Modified:	11 Oct 2023 11:15
URI:	https://shura.shu.ac.uk/id/eprint/32499

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