Department of Dermatology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
J Dermatol. 2018 Jun;45(6):633-691. doi: 10.1111/1346-8138.14162. Epub 2018 Apr 23.
Several effective drugs have been identified for the treatment of systemic sclerosis (SSc). However, in advanced cases, not only their effectiveness is reduced but they may be also harmful due to their side-effects. Therefore, early diagnosis and early treatment is most important for the treatment of SSc. We established diagnostic criteria for SSc in 2003 and early diagnostic criteria for SSc in 2011, for the purpose of developing evaluation of each organ in SSc. Moreover, in November 2013, the American College of Rheumatology and the European Rheumatology Association jointly developed new diagnostic criteria for increasing their sensitivity and specificity, so we revised our diagnostic criteria and severity classification of SSc. Furthermore, we have revised the clinical guideline based on the newest evidence. In particular, the clinical guideline was established by clinical questions based on evidence-based medicine according to the New Minds Clinical Practice Guideline Creation Manual (version 1.0). We aimed to make the guideline easy to use and reliable based on the newest evidence, and to present guidance as specific as possible for various clinical problems in treatment of SSc.
已经有几种有效的药物被确定可用于治疗系统性硬化症（SSc）。然而，在晚期病例中，不仅疗效降低，而且由于其副作用，它们可能还会有害。因此，早期诊断和早期治疗对 SSc 的治疗最为重要。我们在 2003 年建立了 SSc 的诊断标准，在 2011 年建立了 SSc 的早期诊断标准，目的是对 SSc 中每个器官进行评估。此外，2013 年 11 月，美国风湿病学会和欧洲抗风湿病联盟共同制定了新的诊断标准，以提高其敏感性和特异性，因此我们修订了 SSc 的诊断标准和严重程度分类。此外，我们还根据最新证据修订了临床指南。特别是，临床指南是根据循证医学的临床问题，根据最新的《新思维临床实践指南制定手册》（第 1.0 版）制定的。我们的目标是根据最新的证据使指南易于使用和可靠，并为 SSc 治疗中的各种临床问题提供尽可能具体的指导。
