{"id":1084,"date":"2023-09-11T14:56:02","date_gmt":"2023-09-11T14:56:02","guid":{"rendered":"https:\/\/blogs.bmj.com\/rheumsummaries\/?p=1084"},"modified":"2023-09-11T15:02:47","modified_gmt":"2023-09-11T15:02:47","slug":"new-managing-sle-and-ssc-with-non-drug-options","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/rheumsummaries\/2023\/09\/11\/new-managing-sle-and-ssc-with-non-drug-options\/","title":{"rendered":"New: Managing SLE and SSc with non-drug options"},"content":{"rendered":"

This is the lay version of the EULAR recommendations for the non-drug management of people with systemic lupus erythematosus or systemic sclerosis \u2013 two conditions that fall under the umbrella definition of rheumatic diseases. The names are often shorted to SLE or just lupus instead of systemic lupus erythematosus, and scleroderma or SSc instead of systemic sclerosis. The original publication can be downloaded from the EULAR website: www.eular.org<\/a>.<\/p>\n

Parodis I, Girard-Guyonvarc\u2019h C, Arnaud L, et al EULAR recommendations for the non-pharmacological<\/a>
\nmanagement of systemic lupus erythematosus and systemic sclerosis Annals of the Rheumatic<\/a>
\nDiseases Published Online First: 10 July 2023. doi: 10.1136\/ard-2023-224416<\/a><\/p>\n

Introduction<\/strong>
\nEULAR \u2013 the European Alliance of Associations for Rheumatology \u2013 gives advice to doctors, nurses, and
\npatients about the best way to treat and manage diseases. In 2023, EULAR developed new recommendations around non-pharmacological management of SLE and SSc.
\nDoctors, nurses, other healthcare professionals and patients worked together to develop this advice. The
\npatients in the team ensured that the patient point of view was included.<\/p>\n

What do we already know?<\/strong>
\nSystemic lupus erythematosus (SLE) is an inflammatory autoimmune disease. It can affect all organs or
\ntissues, including skin, joints, kidneys, nervous system, lungs, heart, and blood cells. Drugs have been
\ndeveloped in recent years, but people with SLE still experience poor quality of life caused by their health.
\nSystemic sclerosis (SSc) is another rheumatic autoimmune disease. It can affect your blood vessels, as well as cause fibrosis or thickening of the skin and visceral organs. SSc also has a major impact on people\u2019s quality of life. New therapies are promising, but there is still a need to optimize how the disease is managed.
\nIn both SLE and SSc, there is growing evidence to support the use of non-pharmacological and self-management strategies. Drugs are pharmaceutical medicines used to restore, correct, or modify a
\nphysiological function; non-pharmacological options include everything else. They range from patient
\neducation and self-management strategies to exercise, lifestyle changes, counselling, treatments such as
\nacupuncture or hydrotherapy, and minor surgical procedures. These non-drug treatments aim to ease disease symptoms and improve quality of life, as well as help prevent disease worsening. Many of these options are helpful, but they are not standardized, and are often underused in current clinical practice.<\/p>\n

What do the recommendations say?<\/strong>
\nIn total, there are 4 overarching principles and 12 recommendations. The principles say that nonpharmacological management of SLE and SSc should be tailored to individual people\u2019s needs, expectations, and preferences \u2013 and be based on a shared-decision with their healthcare team. They also highlight that nonpharmacological management may be made up of one or more interventions. Importantly, nonpharmacological management should not be used instead of drug treatment, especially when such treatment is required, but rather along with drugs to further improve patient care.
\nThe recommendations are split into three groups, looking at general recommendations across both diseases, and those that apply specifically to either SLE or SSc.
\nEach recommendation is based on the best current knowledge from studies of scientific evidence or expert
\nopinion. The more stars a recommendation has the stronger the evidence is. However, recommendations with limited scientific evidence may be important, because the experts can have a strong opinion even when the published evidence may for various reasons be lacking.<\/p>\n

One star (*) means it is a recommendation with limited scientific evidence.
\nTwo stars (**) means it is a recommendation with some scientific evidence.
\nThree stars (***) means it is a recommendation with quite a lot of scientific evidence.
\nFour stars (****) means it is a recommendation supported with a lot of scientific evidence.<\/p>\n

Recommendations<\/strong>
\nFor the non-pharmacological management of SLE and SSc<\/em><\/p>\n