{"id":1090,"date":"2023-12-11T17:19:58","date_gmt":"2023-12-11T17:19:58","guid":{"rendered":"https:\/\/blogs.bmj.com\/rheumsummaries\/?p=1090"},"modified":"2023-12-11T17:22:37","modified_gmt":"2023-12-11T17:22:37","slug":"updated-sle-recommendations","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/rheumsummaries\/2023\/12\/11\/updated-sle-recommendations\/","title":{"rendered":"Updated: SLE recommendations"},"content":{"rendered":"

This is the lay version of the EULAR recommendations for managing systemic lupus erythematosus. The\u00a0 original publication can be downloaded from the EULAR website: www.eular.org.\u00a0<\/span><\/p>\n

Fanouriakis A, Kostopoulou M, Andersen J, et al EULAR recommendations for the management of systemic <\/span>\u00a0<\/span>lupus erythematosus: 2023 update Annals of the Rheumatic Diseases Published Online First: 12 October <\/span>\u00a0<\/span>2023. doi: 10.1136\/ard-2023-224762<\/span>\u00a0<\/span><\/a><\/p>\n

Introduction
\n<\/b>EULAR \u2013 the European Alliance of Associations for Rheumatology \u2013 gives advice to doctors, nurses, and\u00a0 patients about the best way to treat and manage diseases. In 2023, EULAR updated its recommendations on\u00a0 systemic lupus erythematosus (often shortened to SLE). Doctors, nurses, other health professionals, and\u00a0 patients worked together to develop this new advice. The patients in the team ensured that the patient point\u00a0 of view was included.\u00a0\u00a0<\/span><\/p>\n

What do we already know?
\n<\/b>SLE is an inflammatory autoimmune disease, where the immune system mistakenly attacks tissues in the\u00a0 body. SLE does not look the same in every patient, but it can affect all organs or tissues in the body, including\u00a0 the skin, joints, kidneys, nervous system, lungs, heart, and blood cells. People with SLE can have different\u00a0 symptoms, including fatigue, rash, and joint pain or swelling. There are also a number of different antibodies\u00a0 associated with SLE, which might be detected in a blood test. These include antinuclear antibodies (ANA) and\u00a0 antiphospholipid antibodies (aPL), among others.\u00a0\u00a0<\/span><\/p>\n

EULAR first published recommendations around the management of SLE in 2008. Traditionally, there have\u00a0 not been many treatment options for this disease. However, since the last update in 2019, new drugs have\u00a0 been approved and options are beginning to expand.\u00a0\u00a0<\/span><\/p>\n

Of note, the previous recommendations included 33 statements across four topics. This update has only 13 statements. This structural change is in line with current EULAR practice to streamline the number of\u00a0 recommendation statements in any one publication. Because of this change, all overarching principles and\u00a0 individual recommendations are considered to be new, even where the essence has remained unchanged from the previous version.\u00a0\u00a0<\/span><\/p>\n

What do the recommendations say?
\n<\/b>In total, there are 5 overarching principles and 13 recommendations. The principles say that people with SLE\u00a0 require multidisciplinary, individualized management based on patient education and shared decision-making \u2013 and taking into consideration costs to both the patient and society. Disease activity should be assessed at\u00a0 each clinic visit, and organ damage checked at least annually. Non-pharmacological interventions, such as\u00a0 using sun protection, exercising, stopping smoking, and eating a healthy diet, as well as measures to promote\u00a0 bone health, are important to improve long-term outcomes. Drug treatments should be chosen based on each\u00a0 person\u2019s individual characteristics and preferences, as well as their disease type and severity of organ\u00a0 involvement. Early diagnosis, regular organ screening, prompt treatment, and strict adherence are essential\u00a0 to prevent flares and organ damage, as well as to improve the long-term outcome, and enhance quality of life.\u00a0<\/span><\/p>\n

Each recommendation is based on the best current knowledge from studies of scientific evidence or expert\u00a0 opinion. 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\u00a0 the published evidence may be lacking.\u00a0<\/span><\/p>\n

One star (*) means it is a recommendation with limited scientific evidence.
\n<\/span>Two stars (**) means it is a recommendation with some scientific evidence.
\n<\/span>Three stars (***) means it is a recommendation with quite a lot of scientific evidence.
\n<\/span>Four stars (****) means it is a recommendation supported with a lot of scientific evidence.<\/span>\u00a0<\/span><\/p>\n

Recommendations\u00a0<\/b><\/p>\n