title: EULAR recommendations for the treatment of systemic sclerosis: a report from the EULAR Scleroderma Trials and Research group (EUSTAR).
abstract: OBJECTIVE
  The optimal treatment of systemic sclerosis (SSc) is a challenge because the pathogenesis of SSc is unclear and it is an uncommon and clinically heterogeneous disease affecting multiple organ systems. The aim of the European League Against Rheumatism (EULAR) Scleroderma Trials and Research group (EUSTAR) was to develop evidence-based, consensus-derived recommendations for the treatment of SSc.
  
  
  METHODS
  To obtain and maintain a high level of intrinsic quality and comparability of this approach, EULAR standard operating procedures were followed. The task force comprised 18 SSc experts from Europe, the USA and Japan, two SSc patients and three fellows for literature research. The preliminary set of research questions concerning SSc treatment was provided by 74 EUSTAR centres.
  
  
  RESULTS
  Based on discussion of the clinical research evidence from published literature, and combining this with current expert opinion and clinical experience, 14 recommendations for the treatment of SSc were formulated. The final set includes the following recommendations: three on SSc-related digital vasculopathy (Raynaud's phenomenon and ulcers); four on SSc-related pulmonary arterial hypertension; three on SSc-related gastrointestinal involvement; two on scleroderma renal crisis; one on SSc-related interstitial lung disease and one on skin involvement. Experts also formulated several questions for a future research agenda.
  
  
  CONCLUSIONS
  Evidence-based, consensus-derived recommendations are useful for rheumatologists to help guide treatment for patients with SSc. These recommendations may also help to define directions for future clinical research in SSc.
authors.affiliation: Department of Rheumatology and Internal Medicine, Medical University of Bialystok, Bialystok, Poland.
authors.forename: O
authors.initials: O
authors.lastname: Kowal-Bielecka
authors.forename: R
authors.initials: R
authors.lastname: Landewé
authors.forename: J
authors.initials: J
authors.lastname: Avouac
authors.forename: S
authors.initials: S
authors.lastname: Chwiesko
authors.forename: I
authors.initials: I
authors.lastname: Miniati
authors.forename: L
authors.initials: L
authors.lastname: Czirjak
authors.forename: P
authors.initials: P
authors.lastname: Clements
authors.forename: C
authors.initials: C
authors.lastname: Denton
authors.forename: D
authors.initials: D
authors.lastname: Farge
authors.forename: K
authors.initials: K
authors.lastname: Fligelstone
authors.forename: I
authors.initials: I
authors.lastname: Földvari
authors.forename: D E
authors.initials: DE
authors.lastname: Furst
authors.forename: U
authors.initials: U
authors.lastname: Müller-Ladner
authors.forename: J
authors.initials: J
authors.lastname: Seibold
authors.forename: R M
authors.initials: RM
authors.lastname: Silver
authors.forename: K
authors.initials: K
authors.lastname: Takehara
authors.forename: B Garay
authors.initials: BG
authors.lastname: Toth
authors.forename: A
authors.initials: A
authors.lastname: Tyndall
authors.forename: G
authors.initials: G
authors.lastname: Valentini
authors.forename: F
authors.initials: F
authors.lastname: van den Hoogen
authors.forename: F
authors.initials: F
authors.lastname: Wigley
authors.forename: F
authors.initials: F
authors.lastname: Zulian
authors.forename: Marco
authors.initials: M
authors.lastname: Matucci-Cerinic
mesh_terms: D019317:Evidence-Based Medicine / Q000379:methods; D005767:Gastrointestinal Diseases / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy / Q000209:etiology; D007674:Kidney Diseases / Q000188:drug therapy / Q000209:etiology; D017563:Lung Diseases, Interstitial / Q000188:drug therapy / Q000209:etiology; D011928:Raynaud Disease / Q000188:drug therapy / Q000209:etiology; D012595:Scleroderma, Systemic / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome