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Title:           EULAR recommendations for the treatment of systemic sclerosis: 2023 update
Subject:         Annals of the Rheumatic Diseases, 84 (2025) 29-40. doi:10.1136/ard-2024-226430
Keywords:        "Scleroderma"; "Systemic"; "Therapeutics"; "Connective Tissue Diseases"; "Pulmonary Fibrosis"; "Pulmonary Arterial Hypertension"
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      Title: EULAR recommendations for the treatment of systemic sclerosis: 2023 update
      Destination: Head1
      Children: 
       Item: 
        Title: Introduction
        Destination: Head2
       Item: 
        Title: Methods
        Destination: Head3
       Item: 
        Title: Results
        Destination: Head4
        Children: 
         Item: 
          Title: The vascular therapeutic continuum across Raynaud's, DUs and pulmonary artery hypertension
          Destination: Head5
         Item: 
          Title: Raynaud's phenomenon
          Destination: Head6
          Children: 
           Item: 
            Title: Dihydropyridine-type calcium antagonists, usually oral nifedipine, should be used as first-line therapy for SSc-RP
            Destination: Head7
           Item: 
            Title: PDE5 inhibitors should also be considered for treatment of SSc-RP
            Destination: Head8
           Item: 
            Title: Intravenous iloprost should be considered for severe SSc-RP following failure of oral therapy
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         Item: 
          Title: DU disease
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          Children: 
           Item: 
            Title: PDE5 inhibitors and/or intravenous iloprost should be considered for the treatment of DU in patients with SSc
            Destination: Head11
           Item: 
            Title: Bosentan should be considered for reduction of number of new DU in SSc
            Destination: Head12
         Item: 
          Title: Pulmonary arterial hypertension
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          Children: 
           Item: 
            Title: Combination of PDE-5i and ERAs should be considered as first-line treatment of SSc-PAH
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           Item: 
            Title: Intravenous epoprostenol should be considered for the treatment of SSc patients with advanced PAH (classes III and IV)
            Destination: Head15
           Item: 
            Title: Other prostacyclin analogues should be considered for the treatment of SSc PAH
            Destination: Head16
           Item: 
            Title: Riociguat can be considered for treatment of SSc-PAH
            Destination: Head17
           Item: 
            Title: The use of anticoagulants (warfarin) for the treatment of SSc-PAH is not recommended
            Destination: Head18
         Item: 
          Title: Renal crisis
          Destination: Head19
          Children: 
           Item: 
            Title: ACE inhibitors should be used immediately at diagnosis of SRC
            Destination: Head20
           Item: 
            Title: SSc patients treated with glucocorticoids should have regular monitoring of blood pressure to detect SRC
            Destination: Head21
         Item: 
          Title: GI involvement
          Destination: Head22
          Children: 
           Item: 
            Title: Proton pump inhibitors should be considered for the treatment of SSc gastro-oesophageal reflux disease and prevention of oesophageal ulcers and strictures
            Destination: Head23
           Item: 
            Title: The use of prokinetic drugs should be considered for the treatment of symptomatic motility disturbances related to SSc
            Destination: Head24
           Item: 
            Title: The use of rotating antibiotics should be considered for the treatment of small intestinal bacterial overgrowth
            Destination: Head25
         Item: 
          Title: The immune suppression continuum across skin and lung fibrosis
          Destination: Head26
          Children: 
           Item: 
            Title: Methotrexate, mycophenolate mofetil and/or rituximab should be considered for treatment of SSc skin fibrosis
            Destination: Head27
           Item: 
            Title: Tocilizumab may be considered for the treatment of skin fibrosis in patients with early, inflammatory dcSSc
            Destination: Head28
           Item: 
            Title: Mycophenolate mofetil, cyclophosphamide or rituximab should be considered for the treatment of SSc-ILD
            Destination: Head29
           Item: 
            Title: Nintedanib should be considered alone or in combination with MMF for the treatment of SSc ILD
            Destination: Head30
           Item: 
            Title: Tocilizumab should be considered for the treatment of SSc-ILD
            Destination: Head31
         Item: 
          Title: High-intensity immunosuppression in patients with poor prognosis
          Destination: Head32
         Item: 
          Title: Musculoskeletal involvement
          Destination: Head33
          Children: 
           Item: 
            Title: MTX should be considered for the treatment of musculoskeletal involvement in SSc
            Destination: Head34
         Item: 
          Title: Research agenda and discussion
          Destination: Head35
         Item: 
          Title: Correction notice
          Destination: Head36
         Item: 
          Title: Acknowledgments
          Destination: Head37
         Item: 
          Title: Collaborators
          Destination: Head38
         Item: 
          Title: Contributors
          Destination: Head39
         Item: 
          Title: Funding
          Destination: Head40
         Item: 
          Title: Disclaimer
          Destination: Head41
         Item: 
          Title: Competing interests
          Destination: Head42
         Item: 
          Title: Patient consent for publication
          Destination: Head43
       Item: 
        Title: Supplementary materials
        Destination: Head44
       Item: 
        Title: References
        Destination: Head45
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   Type: CRC32
  Checksum: fa1eb51471b8390a369eaba998fbad09
   Type: MD5
  Checksum: 8e56cf65e46517e9809179b8d95af092021a1b64
   Type: SHA-1
  Checksum: c6e0d21cd1669b216141fdcc4af74c9e25f10d9b942c1b57c5aca79cce014b79
   Type: SHA-256