Worldwide Expert Agreement on Updated Recommendations for the Treatment of Systemic Sclerosis.

{"article_title":"Worldwide Expert Agreement on Updated Recommendations for the Treatment of Systemic Sclerosis.","author":"de Vries-Bouwstra JK, Allanore Y, Matucci-Cerinic M, Balbir-Gurman A","journal_title":"The Journal of rheumatology","issn":"0315-162X","isbn":"","publication_date":"2020 Feb","volume":"47","issue":"2","first_page":"249","page_count":"","accession_number":"31043545","doi":"10.3899\/jrheum.181173","publisher":"Journal Of Rheumatology Publishing Co","doctype":"Journal Article","subjects":"Europe; Adrenal Cortex Hormones therapeutic use; Angiotensin-Converting Enzyme Inhibitors therapeutic use; Fluoxetine therapeutic use; Hematopoietic Stem Cell Transplantation methods; Phosphodiesterase Inhibitors therapeutic use; Practice Guidelines as Topic; Proton Pump Inhibitors therapeutic use; Rheumatologists psychology; Scleroderma, Systemic drug therapy; Europe; Gastroesophageal Reflux prevention & control; Health Services Accessibility; Humans; Hypertension prevention & control; Raynaud Disease prevention & control; Renal Insufficiency prevention & control; Scleroderma, Systemic complications; Scleroderma, Systemic pathology; Severity of Illness Index","interest_area":["Orthopedic"," Immunology Allergy & Inflammation"],"abstract":"Objective: To evaluate agreement of the updated European League Against Rheumatism and European Scleroderma Trials and Research group (EUSTAR) recommendations for treatment of systemic sclerosis (SSc) among international experts. In addition, to determine factors that might influence agreement. Methods: Level of agreement (10-point scale: 0 = not at all, 10 = completely agree) and local drug availability (yes\/no) were assessed using an online survey. The Web link to the survey was shared with 481 unique e-mail addresses and SSc networks (Scleroderma Clinical Trials Consortium, Australian Scleroderma Interest Group, International Systemic Sclerosis Inception Cohort). Level of agreement was compared between subgroups stratified for participant characteristics. Results: In total, 263 experts participated, of whom n = 209 (79%) completed each single item. The majority were rheumatologists (n = 200, 76%) working in Europe (n = 185; 71%); 59% (n = 156) were EUSTAR members; and 57% (n = 151) had > 10 years of clinical experience. Overall level of agreement was high (mean 8.0, SD 2.5). The 3 highest mean agreements included (1) angiotensin-converting enzyme inhibitors for scleroderma renal crisis (9.2, SD 2.1); (2) blood pressure control in SSc-patients treated with corticosteroids (9.0, SD 2.2); (3) proton pump inhibitors to prevent reflux complications (9.0, SD 2.2). The 3 lowest mean agreements included (1) fluoxetine for Raynaud phenomenon (RP; 4.6, SD 2.8); (2) hematopoietic stem cell transplantation (HSCT) for severe SSc (7.1, SD 2.9); (3) phosphodiesterase inhibitors 5 for RP (7.3, SD 2.7). Agreement differed between Europe and non-Europe for the use of iloprost, bosentan, methotrexate, HSCT, and cyclophosphamide. Treatment availability could partially explain differential agreement for iloprost, bosentan, and HSCT. Conclusion: In general, worldwide expert agreement on updated recommendations for treatment of SSc is high, supporting their value. Differences in agreement are partially explained by geographical area and treatment availability.","url":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&db=mdl&AN=31043545&authtype=shib&custid=ns346513","isPdfLink":true,"isSAML":false,"additionalInfo":{"Authored_By":"de Vries-Bouwstra JK, Allanore Y, Matucci-Cerinic M, Balbir-Gurman A","Journal_Info":"Publisher: Journal Of Rheumatology Publishing Co Country of Publication: Canada NLM ID: 7501984 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1499-2752 (Electronic) Linking ISSN: 0315162X NLM ISO Abbreviation: J Rheumatol Subsets: MEDLINE","Publication_Type":"Journal Article","Published_Date":"2020-02-01","Source":"The Journal of rheumatology [J Rheumatol] 2020 Feb; Vol. 47 (2), pp. 249-254. Date of Electronic Publication: 2019 May 01.","Languages":"English","Electronic_ISSN":"1499-2752","MeSH_Terms":"Practice Guidelines as Topic*, Adrenal Cortex Hormones\/*therapeutic use , Angiotensin-Converting Enzyme Inhibitors\/*therapeutic use , Fluoxetine\/*therapeutic use , Hematopoietic Stem Cell Transplantation\/*methods , Phosphodiesterase Inhibitors\/*therapeutic use , Proton Pump Inhibitors\/*therapeutic use , Rheumatologists\/*psychology , Scleroderma, Systemic\/*drug therapy, Europe ; Gastroesophageal Reflux\/prevention & control ; Health Services Accessibility ; Humans ; Hypertension\/prevention & control ; Raynaud Disease\/prevention & control ; Renal Insufficiency\/prevention & control ; Scleroderma, Systemic\/complications ; Scleroderma, Systemic\/pathology ; Severity of Illness Index","Subjects":"Europe, Gastroesophageal Reflux prevention & control, Health Services Accessibility, Humans, Hypertension prevention & control, Raynaud Disease prevention & control, Renal Insufficiency prevention & control, Scleroderma, Systemic complications, Scleroderma, Systemic pathology, Severity of Illness Index, Adrenal Cortex Hormones therapeutic use, Angiotensin-Converting Enzyme Inhibitors therapeutic use, Fluoxetine therapeutic use, Hematopoietic Stem Cell Transplantation methods, Phosphodiesterase Inhibitors therapeutic use, Practice Guidelines as Topic, Proton Pump Inhibitors therapeutic use, Rheumatologists psychology, Scleroderma, Systemic drug therapy","Title_Abbreviations":"The Journal of rheumatology","Volume":"47"},"header":{"DbId":"mdl","DbLabel":"MEDLINE Ultimate","An":"31043545","RelevancyScore":"837","PubType":"Academic Journal","PubTypeId":"academicJournal","PreciseRelevancyScore":"837.158569335938"},"plink":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=31043545&authtype=shib&custid=ns346513&group=main&profile=eds","upload_link":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=31043545&authtype=shib&custid=ns346513&group=main&profile=eds"}