Systemic lupus erythematosus: state of the art on clinical practice guidelines

Farah Tamirou¹, Laurent Arnaud², Rosaria Talarico³, Carlo Alberto Scirè⁴, Tobias Alexander⁵, Zahir Amoura⁶, Tadej Avcin⁷, Alessandra Bortoluzzi⁴, Ricard Cervera⁸, Fabrizio Conti⁹, Alain Cornet¹⁰, Hervé Devilliers¹¹, Andrea Doria¹², Micol Frassi¹³, Micaela Fredi¹³, Marcello Govoni⁴, Frederic Houssiau¹, Ana Lladò¹⁴, Carla Macieira¹⁵, Thierry Martin¹⁶, Laura Massaro⁹, Maria Francisca Moraes-Fontes¹⁴, Cristina Pamfil¹⁶, Sabrina Paolino¹⁷, Chiara Tani³, Sander W Tas^{18

19}, Maria Tektonidou²⁰, Angela Tincani¹³, Ronald F Van Vollenhoven²¹, Stefano Bombardieri²², Gerd Burmester⁵, Fonseca João Eurico¹⁵, Ilaria Galetti²³, Eric Hachulla²⁴, Ulf Mueller-Ladner²⁵, Matthias Schneider²⁶, Vanessa Smith²⁷, Maurizio Cutolo¹⁷, Marta Mosca^{3

28}, Nathalie Costedoat-Chalumeau^{29

30

31}

Affiliations

¹ Rheumatology Department, Cliniques universitaires Saint-Luc, Université catholique deLouvain, Bruxelles, Belgium.
² Service de rhumatologie, Hôpitaux Universitaires de Strasbourg, Centre National de Referencedes Maladies Auto-immunes et Systémiques Rares RESO, Strasbourg, France.
³ Rheumatology Unit, AOU Pisana, Pisa, Italy.
⁴ Section of Rheumatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
⁵ Department of Rheumatology and Clinical Immunology, Charité - University Medicine Berlin, Berlin, Germany.
⁶ Department of Internal Medicine, Hospital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France.
⁷ Department of Allergology, Rheumatology and Clinical Immunology, University Children'sHospital, University Medical Centre Ljubljana, Ljubljana, Slovenia.
⁸ Department of Autoimmune Diseases, Hospital Clínic, Barcelona, Spain.
⁹ Rheumatology Unit, Dipartimento di Medicina Interna e Specialità Mediche, Università degliStudi di Roma La Sapienza, Rome, Italy.
¹⁰ Lupus Europe, Brussels, Belgium.
¹¹ Department of Internal Medicine and Systemic Diseases, François-Mitterrand Teaching Hospital, University of Bourgogne-Franche-Comté, Dijon, France.
¹² Rheumatology Unit, Department of Medicine, AO Padova and University of Padua, Padua, Italy.
¹³ Rheumatology and Clinical Immunology Unit, Civil Hospital, Brescia, Italy.
¹⁴ Unidade de Doenças Auto-imunes/Medicina 7.2, Hospital de Curry Cabral, Centro Hospitalarde Lisboa Central, Lisbon, Portugal.
¹⁵ Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon Academic Medical Centre, Lisbon, Portugal.
¹⁶ Department of Rheumatology, Emergency County Teaching Hospital, Cluj-Napoca, Romania.
¹⁷ Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, IRCCS Polyclinic Hospital San Martino, University of Genoa, Genoa, Italy.
¹⁸ Amsterdam UMC, Department of Clinical Immunology & Rheumatology and Department of Experimental Immunology, Amsterdam Infection and Immunity Institute, Meibergdreef 9, University of Amsterdam, Amsterdam, The Netherlands.
¹⁹ Amsterdam Rheumatology & immunology Center (ARC), Academic Medical Center, Amsterdam, The Netherlands.
²⁰ Joint Rheumatology Academic Program, First Department of Propaedeutic Internal Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
²¹ Clinical Immunology & Rheumatology, Amsterdam Rheumatology & Immunology Center, Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands.
²² University of Pisa, Pisa, Italy.
²³ FESCA - Federation of European Scleroderma Association, Milan, Italy.
²⁴ Département de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Systémiques et Auto-Immunes Rares du Nord-Ouest (CERAINO), LIRIC, INSERM, Univ. Lille, CHU Lille, Lille, France.
²⁵ Department of Rheumatology and Clinical Immunology, Kerckhoff Clinic, Bad Nauheim, Germany.
²⁶ Department of Rheumatology, Universitätsklinikum Düsseldorf, Düsseldorf, Germany.
²⁷ Department of Rheumatology, Department of Internal Medicine, Ghent University Hospital, Ghent University, Ghent, Belgium.
²⁸ Rheumatology Unit, University of Pisa, Pisa, Italy.
²⁹ Assistance Publique-Hôpitaux de Paris (AP-HP), Internal Medicine Department, Cochin Hospital, Referral center for rare autoimmune and systemic diseases, Paris, France.
³⁰ Paris Descartes Sorbonne, Paris Cité University, Paris, France.
³¹ INSERM U 1153, Center for Epidemiology andStatistics Sorbonne Paris Cité (CRESS), Paris, France.

PMID: 30564454
PMCID: PMC6269635
DOI: 10.1136/rmdopen-2018-000793

Review

Systemic lupus erythematosus: state of the art on clinical practice guidelines

Farah Tamirou et al. RMD Open. 2018.

. 2018 Nov 27;4(2):e000793.

doi: 10.1136/rmdopen-2018-000793. eCollection 2018.

Authors

Affiliations

¹ Rheumatology Department, Cliniques universitaires Saint-Luc, Université catholique deLouvain, Bruxelles, Belgium.
² Service de rhumatologie, Hôpitaux Universitaires de Strasbourg, Centre National de Referencedes Maladies Auto-immunes et Systémiques Rares RESO, Strasbourg, France.
³ Rheumatology Unit, AOU Pisana, Pisa, Italy.
⁴ Section of Rheumatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
⁵ Department of Rheumatology and Clinical Immunology, Charité - University Medicine Berlin, Berlin, Germany.
⁶ Department of Internal Medicine, Hospital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France.
⁷ Department of Allergology, Rheumatology and Clinical Immunology, University Children'sHospital, University Medical Centre Ljubljana, Ljubljana, Slovenia.
⁸ Department of Autoimmune Diseases, Hospital Clínic, Barcelona, Spain.
⁹ Rheumatology Unit, Dipartimento di Medicina Interna e Specialità Mediche, Università degliStudi di Roma La Sapienza, Rome, Italy.
¹⁰ Lupus Europe, Brussels, Belgium.
¹¹ Department of Internal Medicine and Systemic Diseases, François-Mitterrand Teaching Hospital, University of Bourgogne-Franche-Comté, Dijon, France.
¹² Rheumatology Unit, Department of Medicine, AO Padova and University of Padua, Padua, Italy.
¹³ Rheumatology and Clinical Immunology Unit, Civil Hospital, Brescia, Italy.
¹⁴ Unidade de Doenças Auto-imunes/Medicina 7.2, Hospital de Curry Cabral, Centro Hospitalarde Lisboa Central, Lisbon, Portugal.
¹⁵ Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon Academic Medical Centre, Lisbon, Portugal.
¹⁶ Department of Rheumatology, Emergency County Teaching Hospital, Cluj-Napoca, Romania.
¹⁷ Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, IRCCS Polyclinic Hospital San Martino, University of Genoa, Genoa, Italy.
¹⁸ Amsterdam UMC, Department of Clinical Immunology & Rheumatology and Department of Experimental Immunology, Amsterdam Infection and Immunity Institute, Meibergdreef 9, University of Amsterdam, Amsterdam, The Netherlands.
¹⁹ Amsterdam Rheumatology & immunology Center (ARC), Academic Medical Center, Amsterdam, The Netherlands.
²⁰ Joint Rheumatology Academic Program, First Department of Propaedeutic Internal Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
²¹ Clinical Immunology & Rheumatology, Amsterdam Rheumatology & Immunology Center, Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands.
²² University of Pisa, Pisa, Italy.
²³ FESCA - Federation of European Scleroderma Association, Milan, Italy.
²⁴ Département de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Systémiques et Auto-Immunes Rares du Nord-Ouest (CERAINO), LIRIC, INSERM, Univ. Lille, CHU Lille, Lille, France.
²⁵ Department of Rheumatology and Clinical Immunology, Kerckhoff Clinic, Bad Nauheim, Germany.
²⁶ Department of Rheumatology, Universitätsklinikum Düsseldorf, Düsseldorf, Germany.
²⁷ Department of Rheumatology, Department of Internal Medicine, Ghent University Hospital, Ghent University, Ghent, Belgium.
²⁸ Rheumatology Unit, University of Pisa, Pisa, Italy.
²⁹ Assistance Publique-Hôpitaux de Paris (AP-HP), Internal Medicine Department, Cochin Hospital, Referral center for rare autoimmune and systemic diseases, Paris, France.
³⁰ Paris Descartes Sorbonne, Paris Cité University, Paris, France.
³¹ INSERM U 1153, Center for Epidemiology andStatistics Sorbonne Paris Cité (CRESS), Paris, France.

PMID: 30564454
PMCID: PMC6269635
DOI: 10.1136/rmdopen-2018-000793

Abstract

Systemic lupus erythematosus (SLE) is the paradigm of systemic autoimmune diseases characterised by a wide spectrum of clinical manifestations with an unpredictable relapsing-remitting course. The aim of the present work was to identify current available clinical practice guidelines (CPGs) for SLE, to provide their review and to identify physicians' and patients' unmet needs. Twenty-three original guidelines published between 2004 and 2017 were identified. Many aspects of disease management are covered, including global disease management, lupus nephritis and neuropsychiatric involvement, management of pregnancies, vaccinations and comorbidities monitoring. Unmet needs relate with disease management of some clinical manifestations and adherence to treatment. Many patient's unmet needs have been identified starting with faster diagnosis, need for more therapeutic options, guidelines on lifestyle issues, attention to quality of life and adequate education.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

**Figure 1**
Flowchart constructed from Pubmed, Embase, and national databases.

See this image and copyright information in PMC

References

1. Woolf SH, Grol R, Hutchinson A, et al. . Clinical guidelines: potential benefits, limitations, and harms of clinical guidelines. BMJ 1999;318:527–30. 10.1136/bmj.318.7182.527 - DOI - PMC - PubMed
1. Andreoli L, Bertsias GK, Agmon-Levin N, et al. . EULAR recommendations for women's health and the management of family planning, assisted reproduction, pregnancy and menopause in patients with systemic lupus erythematosus and/or antiphospholipid syndrome. Ann Rheum Dis 2017;76:476–85. 10.1136/annrheumdis-2016-209770 - DOI - PMC - PubMed
1. Arnaud L, Mathian A, Adoue D, et al. . [Screening and management of cardiovascular risk factors in systemic lupus erythematosus: Recommendations for clinical practice based on the literature and expert opinion]. Rev Med Interne 2015;36:372–80. 10.1016/j.revmed.2014.10.009 - DOI - PubMed
1. Benito-Garcia E, Schur PH, Lahita R, et al. . Guidelines for immunologic laboratory testing in the rheumatic diseases: anti-Sm and anti-RNP antibody tests. Arthritis Rheum 2004;51:1030–44. 10.1002/art.20836 - DOI - PubMed
1. Bertsias G, Ioannidis JP, Boletis J, et al. . 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. Ann Rheum Dis 2008;67:195–205. 10.1136/ard.2007.070367 - DOI - PubMed

Publication types

Actions

LinkOut - more resources

Full Text Sources

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Systemic lupus erythematosus: state of the art on clinical practice guidelines

Affiliations

Systemic lupus erythematosus: state of the art on clinical practice guidelines

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

LinkOut - more resources

Full Text Sources