Article Figures & Data
Tables
- Table 1.
Agreement with the EULAR/EUSTAR recommendations. Data are mean agreement (SD, range) and percent in the top 3 ratings of the survey scale (7–9).
Recommendations Combined North America and Europe, n = 59 North America, n = 41 Europe, n = 18 p SSc-related digital vasculopathy (RP, digital ulcers) 1. Dihydropyridine-type calcium antagonists, usually oral nifedipine, should be considered for first-line therapy for SSc-RP, and intravenous iloprost, or other available intravenous prostanoids, for severe RP. 7.3 (1.6, 3–9) 74.5 7.2 (1.6, 4–9) 77.6 7.5 (1.6, 3–9) 72.2 0.673 2. Intravenous prostanoids (in particular iloprost) should be considered in the treatment of active digital ulcers in patients with SSc. 6.7 (2.5, 0–9) 67.8 6.1 (2.7, 0–9) 58.6 7.8 (1.8, 2–9) 88.9 0.001* 3. Bosentan should be considered in diffuse SSc with multiple digital ulcers after failure of calcium antagonists and, usually, prostanoid therapy. 5.8 (2.5, 0–9) 47.5 5.6 (2.4, 0–9) 43.9 6.3 (2.6, 1–9) 55.6 0.523 SSc-PAH 4. Bosentan should be strongly considered to treat SSc-PAH. 7.7 (1.8, 3–9) 76.3 7.7 (1.8, 3–9) 83.0 7.5 (1.9, 4–9) 61.1 0.547 5. Sitaxentan may also be considered to treat SSc-PAH. 7.7 (1.8, 0–9) 83.1 7.5 (1.9, 0–9) 85.4 7.9 (1.5, 5–9) 77.8 0.445 6. Sildenafil may be considered to treat SSc-PAH. 8.1 (1.5, 2–9) 89.8 8.1 (1.5, 2–9) 95.1 8.1 (1.5, 4–9) 89.0 0.696 7. Intravenous epoprostenol should be considered for the treatment of patients with severe SSc-PAH. 7.8 (2.0, 0–9) 83.1 8.5 (1, 5–9) 95.0 6.5 (2.7, 0–9) 55.5 0.006* SSc-related skin involvement 8. Methotrexate may be considered for treatment of skin manifestations of early diffuse SSc. 5.3 (2.8, 0–9) 40.3 5.2 (3, 0–9) 41.1 5.5 (2.6, 0–9) 38.9 0.962 SSc-ILD 9. Cyclophosphamide should be considered for treatment of SSc-ILD. 7.7 (1.4, 1–9) 84.7 7.7 (1.5, 1–9) 87.6 7.7 (1.2, 6–9) 77.8 0.755 SSc-SRC 10. ACE inhibitors should be used in the treatment of SRC. 8.9 (0.6, 5–9) 98.3 8.9 (0.3, 9) 100 8.8 (0.9, 5–9) 94.5 0.187 11. Patients on steroids should be carefully monitored for blood pressure and renal function. 8.6 (1.0, 4–9) 96.7 8.6 (1.1, 4–9) 95.2 8.6 (0.7, 7–9) 100 0.626 SSc-related gastrointestinal disease 12. PPI should be used for the prevention of SSc-related gastroesophageal reflux, esophageal ulcers and strictures.** 8.3 (1.5, 2–9) 89.9 8.2 (1.7, 2–9) 87.9 8.5 (0.8, 6–9) 94.5 0.518 13. Prokinetic drugs should be used for the management of SSc-related symptomatic motility disturbances (dysphagia, GERD, early satiety, bloating, pseudo-obstruction, etc.). 7.1 (1.9, 0–9) 71.1 7.1 (1.9, 1–9) 70.8 7.1 (2.0, 0–9) 72.3 0.828 14. When malabsorption is caused by bacterial overgrowth, rotating antibiotics may be useful in SSc patients. 8.3 (1.1, 4–9) 93.3 8.4 (1.1, 4–9) 95.2 8.1 (1.1, 6–9) 88.9 0.585 -
↵* Mean North American rheumatologist agreement vs European rheumatologist agreement that was statistically different (p < 0.05).
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↵** Recommendations that had significantly different agreement (p < 0.05) by respondents who were EULAR/EUSTAR recommendation authors vs respondents who were not EULAR/EUSTAR recommendation authors. EULAR: European League Against Rheumatism; EUSTAR: EULAR Scleroderma Trials and Research group; SSc: systemic sclerosis; RP: Raynaud’s phenomenon; PAH: pulmonary arterial hypertension; ILD: interstitial lung disease; SRC: scleroderma renal crisis; ACE: angiotensin-converting enzyme; PPI: proton pump inhibitors; GERD: gastroesophageal reflux disease.
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