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Systematic literature review informing the EULAR recommendations for the non-pharmacological management of systemic lupus erythematosus and systemic sclerosis
Open accessAbstract
Through this systematic literature review, we assembled evidence to inform the EULAR recommendations for the non-pharmacological management of systemic lupus erythematosus (SLE) and systemic sclerosis (SSc). We screened articles published between January 2000 and June 2021. Studies selected for data extraction (118 for SLE and 92 for SSc) were thematically categorised by the character of their intervention. Of 208 articles included, 51 were classified as robust in critical appraisal. Physical activity was the most studied management strategy and was found to be efficacious in both diseases. Patient education and self-management also constituted widely studied topics. Many studies on SLE found psychological interventions to improve quality of life. Studies on SSc found phototherapy and laser treatment to improve cutaneous disease manifestations. In summary, non-pharmacological management of SLE and SSc encompasses a wide range of interventions, which can be combined and provided either with or without adjunct pharmacological treatment but should not aim to substitute the latter when this is deemed required. While some management strategies i.e., physical exercise and patient education, are already established in current clinical practice in several centres, others e.g., phototherapy and laser treatment, show both feasibility and efficacy, yet require testing in more rigorous trials than those hitherto conducted.
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“Expert consensus, including EULAR recommendations, emphasizes a multidisciplinary approach for systemic lupus erythematosus and systemic sclerosis, highlighting the importance of patient education, psychosocial support, and physical therapy in routine care [97].”
From Chronic Stress and Autoimmunity: The Role of HPA Axis and Cortisol Dysregulation (2025) · cites this paper as [97]
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Self-citationChronic Stress and Autoimmunity: The Role of HPA Axis and Cortisol Dysregulation
Nunez, S. G., Rabelo, S. P., Subotic, N., Caruso, J. W., & Knezevic, N. N. (2025) · International Journal of Molecular Sciences · doi:10.3390/ijms26209994 · Cited by 138
“Expert consensus, including EULAR recommendations, emphasizes a multidisciplinary approach for systemic lupus erythematosus and systemic sclerosis, highlighting the importance of patient education, psychosocial support, and physical therapy in routine care [97].”
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Self-citationTsoi, A., Gómez, A., Boström, C., Pezzella, D., Chow, J. W., Girard-Guyonvarc’h, C., Stamm, T., Arnaud, L., & Parodis, I. (2024) · Rheumatology International · doi:10.1007/s00296-024-05548-x · Cited by 35
Self-citation
Metadata
- Authors
- Parodis, I., Gomez, A., Tsoi, A., Chow, J. W., Pezzella, D., Girard, C., Stamm, T. A., & Boström, C.
- Affiliations
- Karolinska University Hospital (SE)
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- University of Geneva (CH)
- Ludwig Boltzmann Gesellschaft (AT)
- Karolinska Institutet (SE)
- Corresponding author
- Parodis, Ioannis
- Venue
- RMD Open
- Publisher
- BMJ
- Published
- 2023-08
- Volume
- 9
- Issue
- 3
- Pages
- e003297
- ISSN
- 2056-5933 (ISSN-L)
- PMC
- PMC10401222
- OpenAlex
- W4385480990
- Cited by
- 44
- References
- 248
- Citations by year
- 2026: 12 · 2025: 12 · 2024: 17 · 2023: 3
- FWCI
- 2.00
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- RMD Open (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- European Alliance of Associations for Rheumatology
- Topics
- Health Sciences › Medicine › Rheumatology › Systemic Sclerosis and Related Diseases
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
- Keywords
- systemic lupus erythematosus, systemic sclerosis, non-pharmacological treatment, physical activity, patient education, self-management, psychological intervention, quality of life, phototherapy, laser therapy, cutaneous manifestations, EULAR recommendations
- MeSH terms
- Humans, Lupus Erythematosus, Systemic, Quality of Life, Scleroderma, Systemic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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