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Portuguese recommendations for the management of Raynaud’s phenomenon and digital ulcers in systemic sclerosis and other connective tissue diseases

2024-06-30Journal article Open access
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dc.contributor.authorSantiago, T.
dc.contributor.authorDuarte, A. C.
dc.contributor.authorSepriano, A.
dc.contributor.authorCastro, A.
dc.contributor.authorRosa, B.
dc.contributor.authorResende, C.
dc.contributor.authorOliveira, D.
dc.contributor.authorDourado, D.
dc.contributor.authorCosta, E.
dc.contributor.authorSantos, F. Cunha
dc.contributor.authorTerroso, G.
dc.contributor.authorBoleto, G.
dc.contributor.authorSilva, I.
dc.contributor.authorBarbosa, L.
dc.contributor.authorSilva, J.
dc.contributor.authorNeves, J. Sousa
dc.contributor.authorSalvador, M. J.
dc.contributor.authorGonçalves, M. J.
dc.contributor.authorGuerra, M. Gomes
dc.contributor.authorFerreira, R. M.
dc.contributor.authorFernandes, R. Duarte
dc.contributor.authorBarreira, S.
dc.contributor.authorTeixeira, C. Silvestre
dc.contributor.authorTomás, A. L.
dc.contributor.authorRomão, V. C.
dc.contributor.authorCordeiro, A.
dc.date.accessioned2024-12-17T11:19:57Z
dc.date.available2024-12-17T11:19:57Z
dc.date.issued2024-06-30
dc.description.abstractObjective: To develop evidence-based recommendations for the non-pharmacological and pharmacological management of Raynaud's phenomenon (RP) and digital ulcers (DUs) in patients with systemic sclerosis and other immune-mediated connective tissue diseases (CTDs). Methods: A task force comprising 21 rheumatologists, 2 surgeons (vascular and plastic), 2 nurses, and 1 patient representative was established. Following a systematic literature review performed to inform the recommendations, statements were formulated and discussed during two meetings (one online and one in-person). Levels of evidence, grades of recommendation (GoR), and level of agreement (LoA) were determined. Results: Five overarching principles and 13 recommendations were developed. GoR ranged from A to D. The mean +/- standard difference (SD) LoA with the overarching principles and recommendations ranged from 7.8 +/- 2.1 to 9.8 +/- 0.4. Briefly, the management of RP and DUs in patients with CTDs should be coordinated by a multidisciplinary team and based on shared decisions with patients. Nifedipine should be used as first-line therapy for RP and/ or DUs. Sildenafil, tadalafil, and/or iloprost IV are second-line options for severe and/or refractory patients with RP and/or DUs. Sildenafil, tadalafil and/or Iloprost IV, should be prescribed for healing and prevention (also including bosentan) of DUs. In patients with RP and/or DUs, non-pharmacological interventions might be considered as add-ons, but there is limited quality and quantity of scientific evidence supporting their use. Conclusions: These recommendations will inform rheumatologists, specialist nurses, other healthcare professionals, and patients about a comprehensive and personalized management of RP and DUs. A research agenda was developed to address unmet needs, particularly for non-pharmacologic interventions.eng
dc.identifier.doi10.63032/ylkm7405
dc.identifier.issn2795-4552
dc.identifier.urihttp://hdl.handle.net/10400.1/26494
dc.language.isoeng
dc.peerreviewedyes
dc.publisherSociedade Portuguesa de Reumatologia
dc.relation.hasversionhttps://www.arprheumatology.com/section.php?id=1689
dc.relation.ispartofARP Rheumatology
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectRaynaud Phenomenon
dc.subjectScleroderma and related disorders
dc.subjectQuality of health care
dc.subjectAttitude of health professionals
dc.subjectPatient attitude to health
dc.titlePortuguese recommendations for the management of Raynaud’s phenomenon and digital ulcers in systemic sclerosis and other connective tissue diseaseseng
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage94
oaire.citation.issue2
oaire.citation.startPage84
oaire.citation.titleARP Rheumatology
oaire.citation.volume3
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

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