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 : 001A09 ( Main/Exploration ); précédent : 001A08; suivant : 001A10EULAR 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
Affiliations:
- Allemagne, Autriche, Belgique, Espagne, France, Grèce, Italie, Norvège, Pays-Bas, Royaume-Uni, République tchèque, Suède
- Angleterre, Attique (région), Bohême centrale, Catalogne, District de Düsseldorf, Grand Londres, Groningue (province), Hollande-Méridionale, Midlands de l'Ouest, Rhénanie-du-Nord-Westphalie, Région de Bruxelles-Capitale, Toscane, Île-de-France, Østlandet
- Athènes, Barcelone, Birmingham, Bruxelles, Düsseldorf, Groningue, Leyde, Londres, Oslo, Paris, Pise, Prague
- Université catholique de Louvain, Université de Birmingham, Université de Pise
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Le document en format XML
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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"><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><wicri:noRegion>Heraklion</wicri:noRegion></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"><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><wicri:noRegion>Ioannina</wicri:noRegion></affiliation></author><author><name sortKey="Boletis, J" sort="Boletis, J" uniqKey="Boletis J" first="J" last="Boletis">J. Boletis</name><affiliation wicri:level="3"><country xml:lang="fr">Grèce</country><wicri:regionArea>Department of Nephrology and Transplantation Medicine, Laiko Hospital, Athens</wicri:regionArea><placeName><settlement type="city">Athènes</settlement><region nuts="2" type="region">Attique (région)</region></placeName></affiliation></author><author><name sortKey="Bombardieri, S" sort="Bombardieri, S" uniqKey="Bombardieri S" first="S" last="Bombardieri">S. Bombardieri</name><affiliation wicri:level="4"><country xml:lang="fr">Italie</country><wicri:regionArea>Cattedra di Reumatologia, Universita di Pisa, Pisa</wicri:regionArea><placeName><settlement type="city">Pise</settlement><region nuts="2">Toscane</region></placeName><orgName type="university">Université de Pise</orgName></affiliation></author><author><name sortKey="Cervera, R" sort="Cervera, R" uniqKey="Cervera R" first="R" last="Cervera">R. Cervera</name><affiliation wicri:level="3"><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Autoimmune Diseases, Hospital Clinic, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Dostal, C" sort="Dostal, C" uniqKey="Dostal C" first="C" last="Dostal">C. Dostal</name><affiliation wicri:level="3"><country xml:lang="fr">République tchèque</country><wicri:regionArea>Institute of Rheumatology, Prague</wicri:regionArea><placeName><settlement type="city">Prague</settlement><region type="région" nuts="2">Bohême centrale</region></placeName></affiliation></author><author><name sortKey="Font, J" sort="Font, J" uniqKey="Font J" first="J" last="Font">J. Font</name><affiliation wicri:level="3"><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Autoimmune Diseases, Hospital Clinic, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></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="3"><country xml:lang="fr">Norvège</country><wicri:regionArea>Department of Rheumatology, Rikshospitalet, Oslo</wicri:regionArea><placeName><settlement type="city">Oslo</settlement><region nuts="2">Østlandet</region></placeName></affiliation></author><author><name sortKey="Houssiau, F" sort="Houssiau, F" uniqKey="Houssiau F" first="F" last="Houssiau">F. Houssiau</name><affiliation wicri:level="4"><country xml:lang="fr">Belgique</country><wicri:regionArea>Rheumatology Department, Université catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels</wicri:regionArea><placeName><settlement type="city">Bruxelles</settlement><region nuts="2">Région de Bruxelles-Capitale</region></placeName><orgName type="university">Université catholique de Louvain</orgName></affiliation></author><author><name sortKey="Huizinga, T" sort="Huizinga, T" uniqKey="Huizinga T" first="T" last="Huizinga">T. Huizinga</name><affiliation wicri:level="3"><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Rheumatology Leiden University Medical Center, Leiden</wicri:regionArea><placeName><settlement type="city">Leyde</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Isenberg, D" sort="Isenberg, D" uniqKey="Isenberg D" first="D" last="Isenberg">D. Isenberg</name><affiliation wicri:level="3"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Rheumatology, University College London Hospitals, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></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="3"><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Clinical Immunology, University Medical Center Groningen, Groningen</wicri:regionArea><placeName><settlement type="city">Groningue</settlement><region nuts="2" type="province">Groningue (province)</region></placeName></affiliation></author><author><name sortKey="Khamashta, M" sort="Khamashta, M" uniqKey="Khamashta M" first="M" last="Khamashta">M. Khamashta</name><affiliation wicri:level="3"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Lupus Research Unit, The Rayne Institute, St Thomas’ Hospital, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></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="3"><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Interne, Groupe Hospitalier Pitié-Salpêtrière, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Schneider, M" sort="Schneider, M" uniqKey="Schneider M" first="M" last="Schneider">M. Schneider</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Rheumatolology, Clinic of Endocrinology, Diabetology and Rheumatology, Heinrich-Heine-University, Dusseldorf</wicri:regionArea><placeName><region type="land" nuts="1">Rhénanie-du-Nord-Westphalie</region><region type="district" nuts="2">District de Düsseldorf</region><settlement type="city">Düsseldorf</settlement></placeName></affiliation></author><author><name sortKey="Smolen, J" sort="Smolen, J" uniqKey="Smolen J" first="J" last="Smolen">J. Smolen</name><affiliation wicri:level="1"><country xml:lang="fr">Autriche</country><wicri:regionArea>Department of Rheumatology, Medical University of Vienna</wicri:regionArea><wicri:noRegion>Medical University of Vienna</wicri:noRegion></affiliation></author><author><name sortKey="Sturfelt, G" sort="Sturfelt, G" uniqKey="Sturfelt G" first="G" last="Sturfelt">G. Sturfelt</name><affiliation wicri:level="1"><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Rheumatology, University Hospital of Lund, Lund</wicri:regionArea><wicri:noRegion>Lund</wicri:noRegion></affiliation></author><author><name sortKey="Tincani, A" sort="Tincani, A" uniqKey="Tincani A" first="A" last="Tincani">A. Tincani</name><affiliation wicri:level="1"><country xml:lang="fr">Italie</country><wicri:regionArea>Rheumatologia e Immunologia Clinica, Ospedale Civile di Brescia</wicri:regionArea><wicri:noRegion>Ospedale Civile di Brescia</wicri:noRegion></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"><country xml:lang="fr">Suède</country><wicri:regionArea>Rheumatology Unit, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Solna</wicri:regionArea><wicri:noRegion>Solna</wicri:noRegion></affiliation></author><author><name sortKey="Gordon, C" sort="Gordon, C" uniqKey="Gordon C" first="C" last="Gordon">C. Gordon</name><affiliation wicri:level="4"><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><placeName><settlement type="city">Birmingham</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Midlands de l'Ouest</region></placeName><orgName type="university">Université de Birmingham</orgName></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"><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><wicri:noRegion>Heraklion</wicri:noRegion></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><affiliations><list><country><li>Allemagne</li><li>Autriche</li><li>Belgique</li><li>Espagne</li><li>France</li><li>Grèce</li><li>Italie</li><li>Norvège</li><li>Pays-Bas</li><li>Royaume-Uni</li><li>République tchèque</li><li>Suède</li></country><region><li>Angleterre</li><li>Attique (région)</li><li>Bohême centrale</li><li>Catalogne</li><li>District de Düsseldorf</li><li>Grand Londres</li><li>Groningue (province)</li><li>Hollande-Méridionale</li><li>Midlands de l'Ouest</li><li>Rhénanie-du-Nord-Westphalie</li><li>Région de Bruxelles-Capitale</li><li>Toscane</li><li>Île-de-France</li><li>Østlandet</li></region><settlement><li>Athènes</li><li>Barcelone</li><li>Birmingham</li><li>Bruxelles</li><li>Düsseldorf</li><li>Groningue</li><li>Leyde</li><li>Londres</li><li>Oslo</li><li>Paris</li><li>Pise</li><li>Prague</li></settlement><orgName><li>Université catholique de Louvain</li><li>Université de Birmingham</li><li>Université de Pise</li></orgName></list><tree><country name="Grèce"><noRegion><name sortKey="Bertsias, G" sort="Bertsias, G" uniqKey="Bertsias G" first="G" last="Bertsias">G. Bertsias</name></noRegion><name sortKey="Boletis, J" sort="Boletis, J" uniqKey="Boletis J" first="J" last="Boletis">J. Boletis</name><name sortKey="Boumpas, D T" sort="Boumpas, D T" uniqKey="Boumpas D" first="D T" last="Boumpas">D T Boumpas</name><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></country><country name="Italie"><region name="Toscane"><name sortKey="Bombardieri, S" sort="Bombardieri, S" uniqKey="Bombardieri S" first="S" last="Bombardieri">S. Bombardieri</name></region><name sortKey="Tincani, A" sort="Tincani, A" uniqKey="Tincani A" first="A" last="Tincani">A. Tincani</name></country><country name="Espagne"><region name="Catalogne"><name sortKey="Cervera, R" sort="Cervera, R" uniqKey="Cervera R" first="R" last="Cervera">R. Cervera</name></region><name sortKey="Font, J" sort="Font, J" uniqKey="Font J" first="J" last="Font">J. Font</name></country><country name="République tchèque"><region name="Bohême centrale"><name sortKey="Dostal, C" sort="Dostal, C" uniqKey="Dostal C" first="C" last="Dostal">C. Dostal</name></region></country><country name="Norvège"><region name="Østlandet"><name sortKey="Gilboe, I M" sort="Gilboe, I M" uniqKey="Gilboe I" first="I M" last="Gilboe">I M Gilboe</name></region></country><country name="Belgique"><region name="Région de Bruxelles-Capitale"><name sortKey="Houssiau, F" sort="Houssiau, F" uniqKey="Houssiau F" first="F" last="Houssiau">F. Houssiau</name></region></country><country name="Pays-Bas"><region name="Hollande-Méridionale"><name sortKey="Huizinga, T" sort="Huizinga, T" uniqKey="Huizinga T" first="T" last="Huizinga">T. Huizinga</name></region><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></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Isenberg, D" sort="Isenberg, D" uniqKey="Isenberg D" first="D" last="Isenberg">D. Isenberg</name></region><name sortKey="Gordon, C" sort="Gordon, C" uniqKey="Gordon C" first="C" last="Gordon">C. Gordon</name><name sortKey="Khamashta, M" sort="Khamashta, M" uniqKey="Khamashta M" first="M" last="Khamashta">M. Khamashta</name></country><country name="France"><region name="Île-de-France"><name sortKey="Piette, J C" sort="Piette, J C" uniqKey="Piette J" first="J C" last="Piette">J C Piette</name></region></country><country name="Allemagne"><region name="Rhénanie-du-Nord-Westphalie"><name sortKey="Schneider, M" sort="Schneider, M" uniqKey="Schneider M" first="M" last="Schneider">M. Schneider</name></region></country><country name="Autriche"><noRegion><name sortKey="Smolen, J" sort="Smolen, J" uniqKey="Smolen J" first="J" last="Smolen">J. Smolen</name></noRegion></country><country name="Suède"><noRegion><name sortKey="Sturfelt, G" sort="Sturfelt, G" uniqKey="Sturfelt G" first="G" last="Sturfelt">G. Sturfelt</name></noRegion><name sortKey="Van Vollenhoven, R" sort="Van Vollenhoven, R" uniqKey="Van Vollenhoven R" first="R" last="Van Vollenhoven">R. Van Vollenhoven</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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