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2018 update of the EULAR recommendations for the management of Behçet's syndrome
Gulen Hatemi1, Robin Christensen2, Dongsik Bang3
1Division of Rheumatology, Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey.
Insights
Updated European League Against Rheumatism (EULAR) recommendations for Behçet's syndrome (BS) management incorporate new treatments. These evidence-based guidelines cover medical and surgical approaches for various BS involvements, aiming to improve patient care.
Area of Science:
- Rheumatology
- Internal Medicine
- Ophthalmology
- Dermatology
- Neurology
- Gastroenterology
- Vascular Surgery
Background:
- Behçet's syndrome (BS) management requires updated guidelines due to new treatment modalities.
- Existing recommendations needed revision to reflect current scientific understanding and therapeutic options.
Purpose of the Study:
- To update European League Against Rheumatism (EULAR) recommendations for Behçet's syndrome (BS) management.
- To incorporate new data and treatment strategies into clinical practice guidelines for BS.
Main Methods:
- A multidisciplinary task force, including BS experts, a methodologist, healthcare professionals, and patients, was assembled.
- Systematic literature review and Delphi approach were used to determine research questions and formulate recommendations.
- EULAR standardised operating procedures guided the development of updated, evidence-based recommendations.
Main Results:
- Recommendations for medical management of mucocutaneous, joint, ocular, vascular, neurological, and gastrointestinal BS were modified.
- Five overarching principles and a new recommendation for surgical management of vascular involvement were added.
- Updated guidelines provide a framework for clinical decision-making in BS patient care.
Conclusions:
- The updated EULAR recommendations offer evidence-based guidance for the medical and surgical management of Behçet's syndrome.
- These guidelines aim to enhance physician care for BS patients and identify priorities for future research.
Abstract:
Several new treatment modalities with different mechanisms of action have been studied in patients with Behçet's syndrome (BS). The aim of the current effort was to update the recommendations in the light of these new data under the auspices of the European League Against Rheumatism (EULAR) Standing Committee for Clinical Affairs. A task force was formed that included BS experts from different specialties including internal medicine, rheumatology, ophthalmology, dermatology, neurology, gastroenterology, oral health medicine and vascular surgery, along with a methodologist, a health professional, two patients and two fellows in charge of the systematic literature search. Research questions were determined using a Delphi approach. EULAR standardised operating procedures was used as the framework. Results of the systematic literature review were presented to the task force during a meeting. The former recommendations were modified or new recommendations were formed after thorough discussions followed by voting. The recommendations on the medical management of mucocutaneous, joint, eye, vascular, neurological and gastrointestinal involvement of BS were modified; five overarching principles and a new recommendation about the surgical management of vascular involvement were added. These updated, evidence-based recommendations are intended to help physicians caring for patients with BS. They also attempt to highlight the shortcomings of the available clinical research with the aim of proposing an agenda for further research priorities.