EULAR recommendations for the management of Sjögren's syndrome with topical and systemic therapies

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EULAR recommendations for the management of Sjögren's syndrome with topical and systemic therapies. / Ramos-Casals, Manel; Brito-Zeron, Pilar; Bombardieri, Stefano; Bootsma, Hendrika; De Vita, Salvatore; Dorner, Thomas; Fisher, Benjamin; Gottenberg, Jacques-Eric; Hernandez-Molina, Gabriela; Kocher, Agnes; Kostov, Belchin; Kruize, Aike; Mandl, Thomas; Ng, Wan-Fai; Retamozo, Soledad; Seror, Raphaele; Shoenfeld, Yehuda; Siso-Almirall, Antoni; Tzioufas, Athanasios; Vitali, Claudio; Bowman, Simon; Mariette, Xavier.

In: Annals of the Rheumatic Diseases, Vol. 79, No. 1, 216114, 01.2020, p. 3-18.

Research output: Contribution to journalArticle

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Ramos-Casals, M, Brito-Zeron, P, Bombardieri, S, Bootsma, H, De Vita, S, Dorner, T, Fisher, B, Gottenberg, J-E, Hernandez-Molina, G, Kocher, A, Kostov, B, Kruize, A, Mandl, T, Ng, W-F, Retamozo, S, Seror, R, Shoenfeld, Y, Siso-Almirall, A, Tzioufas, A, Vitali, C, Bowman, S & Mariette, X 2020, 'EULAR recommendations for the management of Sjögren's syndrome with topical and systemic therapies', Annals of the Rheumatic Diseases, vol. 79, no. 1, 216114, pp. 3-18. https://doi.org/10.1136/annrheumdis-2019-216114, https://doi.org/10.1136/annrheumdis-2019-216114

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Ramos-Casals, Manel ; Brito-Zeron, Pilar ; Bombardieri, Stefano ; Bootsma, Hendrika ; De Vita, Salvatore ; Dorner, Thomas ; Fisher, Benjamin ; Gottenberg, Jacques-Eric ; Hernandez-Molina, Gabriela ; Kocher, Agnes ; Kostov, Belchin ; Kruize, Aike ; Mandl, Thomas ; Ng, Wan-Fai ; Retamozo, Soledad ; Seror, Raphaele ; Shoenfeld, Yehuda ; Siso-Almirall, Antoni ; Tzioufas, Athanasios ; Vitali, Claudio ; Bowman, Simon ; Mariette, Xavier. / EULAR recommendations for the management of Sjögren's syndrome with topical and systemic therapies. In: Annals of the Rheumatic Diseases. 2020 ; Vol. 79, No. 1. pp. 3-18.

Bibtex

@article{27e4358b523f4d4bb84b58b3c69e0e59,
title = "EULAR recommendations for the management of Sj{\"o}gren's syndrome with topical and systemic therapies",
abstract = "The therapeutic management of Sj{\"o}gren syndrome (SjS) has not changed substantially in recent decades: Treatment decisions remain challenging in clinical practice, without a specific therapeutic target beyond the relief of symptoms as the most important goal. In view of this scenario, the European League Against Rheumatism (EULAR) promoted and supported an international collaborative study (EULAR SS Task Force) aimed at developing the first EULAR evidence and consensus-based recommendations for the management of patients with SjS with topical and systemic medications. The aim was to develop a rational therapeutic approach to SjS patients useful for healthcare professionals, physicians undergoing specialist training, medical students, the pharmaceutical industry and drug regulatory organisations following the 2014 EULAR standardised operating procedures. The Task Force (TF) included specialists in rheumatology, internal medicine, oral health, ophthalmology, gynaecology, dermatology and epidemiology, statisticians, general practitioners, nurses and patient representatives from 30 countries of the 5 continents. Evidence was collected from studies including primary SjS patients fulfilling the 2002/2016 criteria; when no evidence was available, evidence from studies including associated SjS or patients fulfilling previous sets of criteria was considered and extrapolated. The TF endorsed the presentation of general principles for the management of patients with SjS as three overarching, general consensus-based recommendations and 12 specific recommendations that form a logical sequence, starting with the management of the central triplet of symptoms (dryness, fatigue and pain) followed by the management of systemic disease. The recommendations address the use of topical oral (saliva substitutes) and ocular (artificial tear drops, topical non-steroidal anti-inflammatory drugs, topical corticosteroids, topical CyA, serum tear drops) therapies, oral muscarinic agonists (pilocarpine, cevimeline), hydroxychloroquine, oral glucocorticoids, synthetic immunosuppressive agents (cyclophosphamide, azathioprine, methotrexate, leflunomide and mycophenolate), and biological therapies (rituximab, abatacept and belimumab). For each recommendation, levels of evidence (mostly modest) and TF agreement (mostly very high) are provided. The 2019 EULAR recommendations are based on the evidence collected in the last 16 years in the management of primary 2002 SjS patients and on discussions between a large and broadly international TF. The recommendations synthesise current thinking on SjS treatment in a set of overarching principles and recommendations. We hope that the current recommendations will be broadly applied in clinical practice and/or serve as a template for national societies to develop local recommendations.",
keywords = "autoimmune diseases, sj{\o}gren's syndrome, treatment",
author = "Manel Ramos-Casals and Pilar Brito-Zeron and Stefano Bombardieri and Hendrika Bootsma and {De Vita}, Salvatore and Thomas Dorner and Benjamin Fisher and Jacques-Eric Gottenberg and Gabriela Hernandez-Molina and Agnes Kocher and Belchin Kostov and Aike Kruize and Thomas Mandl and Wan-Fai Ng and Soledad Retamozo and Raphaele Seror and Yehuda Shoenfeld and Antoni Siso-Almirall and Athanasios Tzioufas and Claudio Vitali and Simon Bowman and Xavier Mariette",
year = "2020",
month = "1",
doi = "10.1136/annrheumdis-2019-216114",
language = "English",
volume = "79",
pages = "3--18",
journal = "Annals of the Rheumatic Diseases",
issn = "0003-4967",
publisher = "BMJ Publishing Group",
number = "1",

}

RIS

TY - JOUR

T1 - EULAR recommendations for the management of Sjögren's syndrome with topical and systemic therapies

AU - Ramos-Casals, Manel

AU - Brito-Zeron, Pilar

AU - Bombardieri, Stefano

AU - Bootsma, Hendrika

AU - De Vita, Salvatore

AU - Dorner, Thomas

AU - Fisher, Benjamin

AU - Gottenberg, Jacques-Eric

AU - Hernandez-Molina, Gabriela

AU - Kocher, Agnes

AU - Kostov, Belchin

AU - Kruize, Aike

AU - Mandl, Thomas

AU - Ng, Wan-Fai

AU - Retamozo, Soledad

AU - Seror, Raphaele

AU - Shoenfeld, Yehuda

AU - Siso-Almirall, Antoni

AU - Tzioufas, Athanasios

AU - Vitali, Claudio

AU - Bowman, Simon

AU - Mariette, Xavier

PY - 2020/1

Y1 - 2020/1

N2 - The therapeutic management of Sjögren syndrome (SjS) has not changed substantially in recent decades: Treatment decisions remain challenging in clinical practice, without a specific therapeutic target beyond the relief of symptoms as the most important goal. In view of this scenario, the European League Against Rheumatism (EULAR) promoted and supported an international collaborative study (EULAR SS Task Force) aimed at developing the first EULAR evidence and consensus-based recommendations for the management of patients with SjS with topical and systemic medications. The aim was to develop a rational therapeutic approach to SjS patients useful for healthcare professionals, physicians undergoing specialist training, medical students, the pharmaceutical industry and drug regulatory organisations following the 2014 EULAR standardised operating procedures. The Task Force (TF) included specialists in rheumatology, internal medicine, oral health, ophthalmology, gynaecology, dermatology and epidemiology, statisticians, general practitioners, nurses and patient representatives from 30 countries of the 5 continents. Evidence was collected from studies including primary SjS patients fulfilling the 2002/2016 criteria; when no evidence was available, evidence from studies including associated SjS or patients fulfilling previous sets of criteria was considered and extrapolated. The TF endorsed the presentation of general principles for the management of patients with SjS as three overarching, general consensus-based recommendations and 12 specific recommendations that form a logical sequence, starting with the management of the central triplet of symptoms (dryness, fatigue and pain) followed by the management of systemic disease. The recommendations address the use of topical oral (saliva substitutes) and ocular (artificial tear drops, topical non-steroidal anti-inflammatory drugs, topical corticosteroids, topical CyA, serum tear drops) therapies, oral muscarinic agonists (pilocarpine, cevimeline), hydroxychloroquine, oral glucocorticoids, synthetic immunosuppressive agents (cyclophosphamide, azathioprine, methotrexate, leflunomide and mycophenolate), and biological therapies (rituximab, abatacept and belimumab). For each recommendation, levels of evidence (mostly modest) and TF agreement (mostly very high) are provided. The 2019 EULAR recommendations are based on the evidence collected in the last 16 years in the management of primary 2002 SjS patients and on discussions between a large and broadly international TF. The recommendations synthesise current thinking on SjS treatment in a set of overarching principles and recommendations. We hope that the current recommendations will be broadly applied in clinical practice and/or serve as a template for national societies to develop local recommendations.

AB - The therapeutic management of Sjögren syndrome (SjS) has not changed substantially in recent decades: Treatment decisions remain challenging in clinical practice, without a specific therapeutic target beyond the relief of symptoms as the most important goal. In view of this scenario, the European League Against Rheumatism (EULAR) promoted and supported an international collaborative study (EULAR SS Task Force) aimed at developing the first EULAR evidence and consensus-based recommendations for the management of patients with SjS with topical and systemic medications. The aim was to develop a rational therapeutic approach to SjS patients useful for healthcare professionals, physicians undergoing specialist training, medical students, the pharmaceutical industry and drug regulatory organisations following the 2014 EULAR standardised operating procedures. The Task Force (TF) included specialists in rheumatology, internal medicine, oral health, ophthalmology, gynaecology, dermatology and epidemiology, statisticians, general practitioners, nurses and patient representatives from 30 countries of the 5 continents. Evidence was collected from studies including primary SjS patients fulfilling the 2002/2016 criteria; when no evidence was available, evidence from studies including associated SjS or patients fulfilling previous sets of criteria was considered and extrapolated. The TF endorsed the presentation of general principles for the management of patients with SjS as three overarching, general consensus-based recommendations and 12 specific recommendations that form a logical sequence, starting with the management of the central triplet of symptoms (dryness, fatigue and pain) followed by the management of systemic disease. The recommendations address the use of topical oral (saliva substitutes) and ocular (artificial tear drops, topical non-steroidal anti-inflammatory drugs, topical corticosteroids, topical CyA, serum tear drops) therapies, oral muscarinic agonists (pilocarpine, cevimeline), hydroxychloroquine, oral glucocorticoids, synthetic immunosuppressive agents (cyclophosphamide, azathioprine, methotrexate, leflunomide and mycophenolate), and biological therapies (rituximab, abatacept and belimumab). For each recommendation, levels of evidence (mostly modest) and TF agreement (mostly very high) are provided. The 2019 EULAR recommendations are based on the evidence collected in the last 16 years in the management of primary 2002 SjS patients and on discussions between a large and broadly international TF. The recommendations synthesise current thinking on SjS treatment in a set of overarching principles and recommendations. We hope that the current recommendations will be broadly applied in clinical practice and/or serve as a template for national societies to develop local recommendations.

KW - autoimmune diseases

KW - sjøgren's syndrome

KW - treatment

UR - http://www.scopus.com/inward/record.url?scp=85074464125&partnerID=8YFLogxK

U2 - 10.1136/annrheumdis-2019-216114

DO - 10.1136/annrheumdis-2019-216114

M3 - Article

C2 - 31672775

VL - 79

SP - 3

EP - 18

JO - Annals of the Rheumatic Diseases

JF - Annals of the Rheumatic Diseases

SN - 0003-4967

IS - 1

M1 - 216114

ER -