目的：为沙特阿拉伯系统性红斑狼疮（SLE）的管理提供循证临床实践建议。
方法：本EULAR适应的国家指南，其中多学科工作组利用改良的Delphi方法制定了31个临床关键问题。自EULAR发表以来，进行了系统的文献综述以更新证据。达成共识后，进行了两轮投票和小组讨论，以产生综合建议/声明。
结果：沙特阿拉伯有相当数量的患者在就诊风湿病专家方面出现延误，强调及时转诊SLE专家或风湿病专家以确保准确诊断和及时治疗的重要性。糖皮质激素（GC）治疗SLE患者的主要目标是建立最小剂量和持续时间的疾病控制。类固醇保护剂的利用促进了类固醇保护剂的目标。所有SLE患者建议使用羟氯喹，尽管医生必须仔细监测毒性并优先考虑定期的药物依从性评估。怀孕期间的SLE管理从孕前开始，通过评估疾病活动，主要器官受累，高凝状态，以及可能对母体和胎儿结局产生负面影响的伴随疾病。密切监测的多学科护理可以优化母婴结局。对于具有抗磷脂抗体的患者，推荐低剂量阿司匹林预防.此外，长期使用抗凝药物是预防因血栓形成高复发引起的继发性抗磷脂综合征的基础。
结论：本沙特阿拉伯国家SLE管理临床实践指南为沙特阿拉伯管理SLE患者的医疗保健提供者提供了循证建议和指导。这些指南将有助于规范医疗服务，改善提供者的教育，并可能为SLE患者带来更好的治疗结果。
OBJECTIVE: To provide evidence-based clinical practice recommendations for managing Systemic Lupus Erythematosus (SLE) in Saudi Arabia.
METHODS: This EULAR-adapted national
guideline in which a multidisciplinary task force utilized the modified Delphi method to develop 31 clinical key questions. A systematic literature review was conducted to update the evidence since the EULAR publication. After reaching a
consensus agreement, two rounds of voting and group discussion were conducted to generate consolidated recommendations/statements.
RESULTS: A significant number of patients in Saudi Arabia experience delays in accessing rheumatologists, highlighting the significance of timely referral to SLE specialists or rheumatologists to ensure accurate diagnosis and prompt treatment. The primary goal of Glucocorticoid (GC) therapy in SLE patients is to establish disease control with a minimum dose and duration. Steroid-sparing agent utilization facilitates steroid-sparing goals. Hydroxychloroquine is recommended for all SLE patients, though physicians must carefully monitor toxicity and prioritize regular medication adherence assessment. SLE management during pregnancy starts from preconception time by assessing disease activity, major organ involvement, hypercoagulability status, and concomitant diseases that may negatively impact maternal and fetal outcomes. Multidisciplinary care with close monitoring may optimize both maternal and fetal outcomes. For patients with antiphospholipid antibodies, low-dose aspirin prophylaxis is recommended. Also, Long-term anticoagulant medications are fundamental to prevent secondary antiphospholipid syndrome due to high thrombosis recurrence.
CONCLUSIONS: This Saudi National Clinical Practice
guidelines for
SLE management provide evidence-based recommendations and guidance for healthcare providers in Saudi Arabia who are managing patients with SLE. These
guidelines will help to standardize healthcare service, improve provider education, and perhaps lead to better treatment outcomes for
SLE patients.
