EULAR recommendations for the management of systemic lupus erythematosus. Report of a Task Force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics
Identifieur interne : 002032 ( Istex/Curation ); précédent : 002031; suivant : 002033EULAR recommendations for the management of systemic lupus erythematosus. Report of a Task Force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics
Auteurs : G. Bertsias [Grèce] ; J P A. Ioannidis [Grèce] ; J. Boletis [Grèce] ; S. Bombardieri [Italie] ; R. Cervera [Espagne] ; C. Dostal [République tchèque] ; J. Font [Espagne] ; I M Gilboe [Norvège] ; F. Houssiau [Belgique] ; T. Huizinga [Pays-Bas] ; D. Isenberg [Royaume-Uni] ; C G M. Kallenberg [Pays-Bas] ; M. Khamashta [Royaume-Uni] ; J C Piette [France] ; M. Schneider [Allemagne] ; J. Smolen [Autriche] ; G. Sturfelt [Suède] ; A. Tincani [Italie] ; R. Van Vollenhoven [Suède] ; C. Gordon [Royaume-Uni] ; D T Boumpas [Grèce]Source :
- Annals of the Rheumatic Diseases [ 0003-4967 ] ; 2008-02.
English descriptors
- Teeft :
- Antiphospholipid, Antiphospholipid antibodies, Antiphospholipid syndrome, Arthritis, Arthritis rheum, Aspirin, Azathioprine, Boumpas, Cohort, Cyclophosphamide, Damage accrual, Disease activity, Engl, Erythematosus, Eular, Expert committee, Expert opinion, Fetal, Gladman, Glucocorticoid, Hydroxychloroquine, Immunosuppressive, Induction therapy, Intravenous, Lupus, Lupus erythematosus, Lupus nephritis, Lupus pregnancy, Mofetil, Morbidity, Mycophenolate, Mycophenolate mofetil, Nephritis, Neuropsychiatric, Neuropsychiatric lupus, Neuropsychiatric manifestations, Oral anticoagulation, Osteoporosis, Predictor, Pregnancy, Pregnancy loss, Prognostic, Proliferative, Proliferative lupus nephritis, Prospective study, Randomised trials, Randomized, Recurrent thrombosis, Relapse, Renal, Renal disease, Renal transplantation, Rheum, Rheumatol, Rheumatology, Risk factors, Syndrome, Systemic, Systemic lupus erythematosus, Thrombosis, Transplantation, Urowitz.
Abstract
Objective: Systemic lupus erythematosus (SLE) is a complex disease with variable presentations, course and prognosis. We sought to develop evidence-based recommendations addressing the major issues in the management of SLE. Methods: The EULAR Task Force on SLE comprised 19 specialists and a clinical epidemiologist. Key questions for the management of SLE were compiled using the Delphi technique. A systematic search of PubMed and Cochrane Library Reports was performed using McMaster/Hedges clinical queries’ strategies for questions related to the diagnosis, prognosis, monitoring and treatment of SLE. For neuropsychiatric, pregnancy and antiphospholipid syndrome questions, the search was conducted using an array of relevant terms. Evidence was categorised based on sample size and type of design, and the categories of available evidence were identified for each recommendation. The strength of recommendation was assessed based on the category of available evidence, and agreement on the statements was measured across the 19 specialists. Results: Twelve questions were generated regarding the prognosis, diagnosis, monitoring and treatment of SLE, including neuropsychiatric SLE, pregnancy, the antiphospholipid syndrome and lupus nephritis. The evidence to support each proposition was evaluated and scored. After discussion and votes, the final recommendations were presented using brief statements. The average agreement among experts was 8.8 out of 10. Conclusion: Recommendations for the management of SLE were developed using an evidence-based approach followed by expert consensus with high level of agreement among the experts.
Url:
DOI: 10.1136/ard.2007.070367
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Report of a Task Force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics</title><author><name sortKey="Bertsias, G" sort="Bertsias, G" uniqKey="Bertsias G" first="G" last="Bertsias">G. Bertsias</name><affiliation wicri:level="1"><mods:affiliation>Internal Medicine, and Rheumatology, Clinical Immunology and Allergy, University of Crete School of Medicine, Heraklion, Greece</mods:affiliation><country xml:lang="fr">Grèce</country><wicri:regionArea>Internal Medicine, and Rheumatology, Clinical Immunology and Allergy, University of Crete School of Medicine, Heraklion</wicri:regionArea></affiliation></author><author><name sortKey="Ioannidis, J P A" sort="Ioannidis, J P A" uniqKey="Ioannidis J" first="J P A" last="Ioannidis">J P A. Ioannidis</name><affiliation wicri:level="1"><mods:affiliation>Clinical Trials and Evidence-Based Medicine Unit, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece</mods:affiliation><country xml:lang="fr">Grèce</country><wicri:regionArea>Clinical Trials and Evidence-Based Medicine Unit, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina</wicri:regionArea></affiliation></author><author><name sortKey="Boletis, J" sort="Boletis, J" uniqKey="Boletis J" first="J" last="Boletis">J. Boletis</name><affiliation wicri:level="1"><mods:affiliation>Department of Nephrology and Transplantation Medicine, Laiko Hospital, Athens, Greece</mods:affiliation><country xml:lang="fr">Grèce</country><wicri:regionArea>Department of Nephrology and Transplantation Medicine, Laiko Hospital, Athens</wicri:regionArea></affiliation></author><author><name sortKey="Bombardieri, S" sort="Bombardieri, S" uniqKey="Bombardieri S" first="S" last="Bombardieri">S. Bombardieri</name><affiliation wicri:level="1"><mods:affiliation>Cattedra di Reumatologia, Universita di Pisa, Pisa, Italy</mods:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Cattedra di Reumatologia, Universita di Pisa, Pisa</wicri:regionArea></affiliation></author><author><name sortKey="Cervera, R" sort="Cervera, R" uniqKey="Cervera R" first="R" last="Cervera">R. Cervera</name><affiliation wicri:level="1"><mods:affiliation>Department of Autoimmune Diseases, Hospital Clinic, Barcelona, Spain</mods:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Autoimmune Diseases, Hospital Clinic, Barcelona</wicri:regionArea></affiliation></author><author><name sortKey="Dostal, C" sort="Dostal, C" uniqKey="Dostal C" first="C" last="Dostal">C. Dostal</name><affiliation wicri:level="1"><mods:affiliation>Institute of Rheumatology, Prague, Czech Republic</mods:affiliation><country xml:lang="fr">République tchèque</country><wicri:regionArea>Institute of Rheumatology, Prague</wicri:regionArea></affiliation></author><author><name sortKey="Font, J" sort="Font, J" uniqKey="Font J" first="J" last="Font">J. Font</name><affiliation wicri:level="1"><mods:affiliation>Department of Autoimmune Diseases, Hospital Clinic, Barcelona, Spain</mods:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Autoimmune Diseases, Hospital Clinic, Barcelona</wicri:regionArea></affiliation></author><author><name sortKey="Gilboe, I M" sort="Gilboe, I M" uniqKey="Gilboe I" first="I M" last="Gilboe">I M Gilboe</name><affiliation wicri:level="1"><mods:affiliation>Department of Rheumatology, Rikshospitalet, Oslo, Norway</mods:affiliation><country xml:lang="fr">Norvège</country><wicri:regionArea>Department of Rheumatology, Rikshospitalet, Oslo</wicri:regionArea></affiliation></author><author><name sortKey="Houssiau, F" sort="Houssiau, F" uniqKey="Houssiau F" first="F" last="Houssiau">F. Houssiau</name><affiliation wicri:level="1"><mods:affiliation>Rheumatology Department, Université catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium</mods:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Rheumatology Department, Université catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels</wicri:regionArea></affiliation></author><author><name sortKey="Huizinga, T" sort="Huizinga, T" uniqKey="Huizinga T" first="T" last="Huizinga">T. Huizinga</name><affiliation wicri:level="1"><mods:affiliation>Department of Rheumatology Leiden University Medical Center, Leiden, The Netherlands</mods:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Rheumatology Leiden University Medical Center, Leiden</wicri:regionArea></affiliation></author><author><name sortKey="Isenberg, D" sort="Isenberg, D" uniqKey="Isenberg D" first="D" last="Isenberg">D. Isenberg</name><affiliation wicri:level="1"><mods:affiliation>Centre for Rheumatology, University College London Hospitals, London, UK</mods:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Rheumatology, University College London Hospitals, London</wicri:regionArea></affiliation></author><author><name sortKey="Kallenberg, C G M" sort="Kallenberg, C G M" uniqKey="Kallenberg C" first="C G M" last="Kallenberg">C G M. Kallenberg</name><affiliation wicri:level="1"><mods:affiliation>Department of Clinical Immunology, University Medical Center Groningen, Groningen, The Netherlands</mods:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Clinical Immunology, University Medical Center Groningen, Groningen</wicri:regionArea></affiliation></author><author><name sortKey="Khamashta, M" sort="Khamashta, M" uniqKey="Khamashta M" first="M" last="Khamashta">M. Khamashta</name><affiliation wicri:level="1"><mods:affiliation>Lupus Research Unit, The Rayne Institute, St Thomas’ Hospital, London, UK</mods:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Lupus Research Unit, The Rayne Institute, St Thomas’ Hospital, London</wicri:regionArea></affiliation></author><author><name sortKey="Piette, J C" sort="Piette, J C" uniqKey="Piette J" first="J C" last="Piette">J C Piette</name><affiliation wicri:level="1"><mods:affiliation>Service de Médecine Interne, Groupe Hospitalier Pitié-Salpêtrière, Paris, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Interne, Groupe Hospitalier Pitié-Salpêtrière, Paris</wicri:regionArea></affiliation></author><author><name sortKey="Schneider, M" sort="Schneider, M" uniqKey="Schneider M" first="M" last="Schneider">M. Schneider</name><affiliation wicri:level="1"><mods:affiliation>Rheumatolology, Clinic of Endocrinology, Diabetology and Rheumatology, Heinrich-Heine-University, Dusseldorf, Germany</mods:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Rheumatolology, Clinic of Endocrinology, Diabetology and Rheumatology, Heinrich-Heine-University, Dusseldorf</wicri:regionArea></affiliation></author><author><name sortKey="Smolen, J" sort="Smolen, J" uniqKey="Smolen J" first="J" last="Smolen">J. Smolen</name><affiliation wicri:level="1"><mods:affiliation>Department of Rheumatology, Medical University of Vienna, Austria</mods:affiliation><country xml:lang="fr">Autriche</country><wicri:regionArea>Department of Rheumatology, Medical University of Vienna</wicri:regionArea></affiliation></author><author><name sortKey="Sturfelt, G" sort="Sturfelt, G" uniqKey="Sturfelt G" first="G" last="Sturfelt">G. Sturfelt</name><affiliation wicri:level="1"><mods:affiliation>Department of Rheumatology, University Hospital of Lund, Lund, Sweden</mods:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Rheumatology, University Hospital of Lund, Lund</wicri:regionArea></affiliation></author><author><name sortKey="Tincani, A" sort="Tincani, A" uniqKey="Tincani A" first="A" last="Tincani">A. Tincani</name><affiliation wicri:level="1"><mods:affiliation>Rheumatologia e Immunologia Clinica, Ospedale Civile di Brescia, Italy</mods:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Rheumatologia e Immunologia Clinica, Ospedale Civile di Brescia</wicri:regionArea></affiliation></author><author><name sortKey="Van Vollenhoven, R" sort="Van Vollenhoven, R" uniqKey="Van Vollenhoven R" first="R" last="Van Vollenhoven">R. Van Vollenhoven</name><affiliation wicri:level="1"><mods:affiliation>Rheumatology Unit, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden</mods:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Rheumatology Unit, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Solna</wicri:regionArea></affiliation></author><author><name sortKey="Gordon, C" sort="Gordon, C" uniqKey="Gordon C" first="C" last="Gordon">C. Gordon</name><affiliation wicri:level="1"><mods:affiliation>Centre for Immune Regulation, Division of Immunity and Infection, The University of Birmingham, Birmingham, UK</mods:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Immune Regulation, Division of Immunity and Infection, The University of Birmingham, Birmingham</wicri:regionArea></affiliation></author><author><name sortKey="Boumpas, D T" sort="Boumpas, D T" uniqKey="Boumpas D" first="D T" last="Boumpas">D T Boumpas</name><affiliation wicri:level="1"><mods:affiliation>Internal Medicine, and Rheumatology, Clinical Immunology and Allergy, University of Crete School of Medicine, Heraklion, Greece</mods:affiliation><country xml:lang="fr">Grèce</country><wicri:regionArea>Internal Medicine, and Rheumatology, Clinical Immunology and Allergy, University of Crete School of Medicine, Heraklion</wicri:regionArea></affiliation></author></analytic><monogr></monogr><series><title level="j">Annals of the Rheumatic Diseases</title><title level="j" type="abbrev">Ann Rheum Dis</title><idno type="ISSN">0003-4967</idno><idno type="eISSN">1468-2060</idno><imprint><publisher>BMJ Publishing Group Ltd and European League Against Rheumatism</publisher><date type="published" when="2008-02">2008-02</date><biblScope unit="volume">67</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="195">195</biblScope></imprint><idno type="ISSN">0003-4967</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0003-4967</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="Teeft" xml:lang="en"><term>Antiphospholipid</term><term>Antiphospholipid antibodies</term><term>Antiphospholipid syndrome</term><term>Arthritis</term><term>Arthritis rheum</term><term>Aspirin</term><term>Azathioprine</term><term>Boumpas</term><term>Cohort</term><term>Cyclophosphamide</term><term>Damage accrual</term><term>Disease activity</term><term>Engl</term><term>Erythematosus</term><term>Eular</term><term>Expert committee</term><term>Expert opinion</term><term>Fetal</term><term>Gladman</term><term>Glucocorticoid</term><term>Hydroxychloroquine</term><term>Immunosuppressive</term><term>Induction therapy</term><term>Intravenous</term><term>Lupus</term><term>Lupus erythematosus</term><term>Lupus nephritis</term><term>Lupus pregnancy</term><term>Mofetil</term><term>Morbidity</term><term>Mycophenolate</term><term>Mycophenolate mofetil</term><term>Nephritis</term><term>Neuropsychiatric</term><term>Neuropsychiatric lupus</term><term>Neuropsychiatric manifestations</term><term>Oral anticoagulation</term><term>Osteoporosis</term><term>Predictor</term><term>Pregnancy</term><term>Pregnancy loss</term><term>Prognostic</term><term>Proliferative</term><term>Proliferative lupus nephritis</term><term>Prospective study</term><term>Randomised trials</term><term>Randomized</term><term>Recurrent thrombosis</term><term>Relapse</term><term>Renal</term><term>Renal disease</term><term>Renal transplantation</term><term>Rheum</term><term>Rheumatol</term><term>Rheumatology</term><term>Risk factors</term><term>Syndrome</term><term>Systemic</term><term>Systemic lupus erythematosus</term><term>Thrombosis</term><term>Transplantation</term><term>Urowitz</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Objective: Systemic lupus erythematosus (SLE) is a complex disease with variable presentations, course and prognosis. We sought to develop evidence-based recommendations addressing the major issues in the management of SLE. Methods: The EULAR Task Force on SLE comprised 19 specialists and a clinical epidemiologist. Key questions for the management of SLE were compiled using the Delphi technique. A systematic search of PubMed and Cochrane Library Reports was performed using McMaster/Hedges clinical queries’ strategies for questions related to the diagnosis, prognosis, monitoring and treatment of SLE. For neuropsychiatric, pregnancy and antiphospholipid syndrome questions, the search was conducted using an array of relevant terms. Evidence was categorised based on sample size and type of design, and the categories of available evidence were identified for each recommendation. The strength of recommendation was assessed based on the category of available evidence, and agreement on the statements was measured across the 19 specialists. Results: Twelve questions were generated regarding the prognosis, diagnosis, monitoring and treatment of SLE, including neuropsychiatric SLE, pregnancy, the antiphospholipid syndrome and lupus nephritis. The evidence to support each proposition was evaluated and scored. After discussion and votes, the final recommendations were presented using brief statements. The average agreement among experts was 8.8 out of 10. Conclusion: Recommendations for the management of SLE were developed using an evidence-based approach followed by expert consensus with high level of agreement among the experts.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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