Galoppini Giorgio, Marangoni Antonio, Cirilli Francesca, Ruffilli Francesca, Garaffoni Carlo, Govoni Marcello, Scirè Carlo Alberto, Silvagni Ettore, Bortoluzzi Alessandra
Rheumatology Unit, Department of Medical Sciences, Università degli Studi di Ferrara, Azienda Ospedaliero-Universitaria S. Anna, 44124 Cona, Italy.
School of Medicine, University of Milano Bicocca, 20126 Milan, Italy.
J Clin Med. 2023 Jun 15;12(12):4059. doi: 10.3390/jcm12124059.
Systemic lupus erythematosus (SLE) is characterized by multisystemic clinical manifestations ranging from a relatively mild involvement to potentially life-threatening complications. Due to this complexity, a multidisciplinary (MD) approach is the best strategy for optimizing patients' care. The main aim of this systematic literature review (SLR) was to scrutinize the published data regarding the MD approach for the management of SLE patients. The secondary objective was to evaluate the outcomes of the MD approach in SLE patients. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were used. We performed an SLR to retrieve articles available in English or Italian listed in PubMed, Embase, Cinahl, and Cochrane Library concerning the MD approach used in observational studies and clinical trials. Four independent reviewers performed the study selection and data collection. Of 5451 abstracts evaluated, 19 studies were included in the SLR. The MD approach was most frequently described in the context of SLE pregnancy, reported in 10 papers. MD teams were composed of a rheumatologist, except for one cohort study; a gynecologist; a psychologist; a nurse; and other health professionals. MD approaches had a positive impact on pregnancy-related complications and disease flares and improved SLE psychological impact. Although international recommendations advise an MD approach for managing SLE, our review highlighted the paucity of data supporting this strategy, with most of the available evidence on the management of SLE during pregnancy.
系统性红斑狼疮（SLE）的特征是多系统临床表现，从相对轻微的受累到潜在的危及生命的并发症。由于这种复杂性，多学科（MD）方法是优化患者护理的最佳策略。本系统文献综述（SLR）的主要目的是仔细审查已发表的关于MD方法治疗SLE患者的数据。次要目标是评估MD方法在SLE患者中的治疗效果。使用了系统评价和Meta分析的首选报告项目指南。我们进行了一项SLR，以检索PubMed、Embase、Cinahl和Cochrane图书馆中列出的英文或意大利文文章，这些文章涉及观察性研究和临床试验中使用的MD方法。四名独立评审员进行了研究选择和数据收集。在评估的5451篇摘要中，有19项研究被纳入SLR。MD方法在SLE妊娠背景下被描述得最为频繁，有10篇论文报道。除了一项队列研究外，MD团队由一名风湿病学家、一名妇科医生、一名心理学家、一名护士和其他卫生专业人员组成。MD方法对妊娠相关并发症和疾病发作有积极影响，并改善了SLE的心理影响。尽管国际指南建议采用MD方法管理SLE，但我们的综述强调支持这一策略的数据匮乏，大多数现有证据是关于妊娠期间SLE的管理。
