15 March 2023

A new revision of the BSR systemic sclerosis (SSc) guideline will provide a practical roadmap for the management of SSc that builds upon the previous treatment guideline to incorporate advances in evidence-based treatment and increased knowledge about the assessment, classification, and management.

With important new trials and evidence-based therapies for the treatment of SSc, together with changes in NHS England prescribing policies, the present BSR guideline for SSc now requires updating. Today we see the publication of the guideline scope: a key paper outlining what the guideline will cover.

SSc has the highest mortality of any of the autoimmune rheumatic diseases with approximately half of people affected eventually dying as a direct result of the disease or a related complication. Current management is generally centred on rheumatology clinics in a secondary care setting with appropriate involvement and cross-referral to other specialties including dermatology, respiratory medicine, gastroenterology and others. There are important shared care links with other specialists.

Chair of the guideline working group (GWG), Professor Christopher Denton based at UCL and consultant rheumatologist at Royal Free Hospital, London, said, “There are many management challenges that will be considered in the guideline to harmonise care and define auditable standards. A multi-professional representation in the guideline working group has been very important with experts across dermatology, podiatry, respiratory medicine and pharmacy, as well as paediatric specialists and lay members.”

Lay member of the GWG, Kim Fligelstone, a patient with SSc, said, “If SSc isn’t diagnosed early it can lead to a lot of severe complications, so it is great that this guideline update will consider recent advances in understanding early identification of the disease. Another important addition is that the revision will now cover people of all ages with SSc, and the lay summary of the scope also helps to clearly show what this guideline will cover.”

The scope published today describes the key issues for patients with SSc and includes draft questions related to them. These will be used to develop more detailed review questions, which guide the systematic review of the literature.

The full scope can be accessed now in the BSR open-access journal, Rheumatology Advances In Practice, here.

Access all the BSR guidelines via the guidelines homepage.

NICE accredits our clinical guideline process; this is valid until December 2023.