POS1506-HPR SYSTEMATIC LITERATURE REVIEW TO INFORM THE EULAR TASK FORCE FOR RECOMMENDATIONS/POINTS TO CONSIDER FOR THE NON-PHARMACOLOGICAL MANAGEMENT OF SYSTEMIC LUPUS ERYTHEMATOSUS AND SYSTEMIC SCLEROSIS

Background The heterogeneity and complexity of the chronic autoimmune diseases systemic lupus erythematosus (SLE) sclerosis (SSc) necessitate comprehensive person-centred management, including non-pharmacological approaches. Recommendations for management are currently lacking. Objectives To perform a systematic literature review to inform EULAR task force recommendations/points consider adult patients with SLE SSc. Among research questions formulated by force, we aimed at identifying (i) interventions that have been evaluated (ii) their target health domains or organ systems. Methods We searched Medline, Embase, Web Science Core Collection CINAHL articles published between January 2000 June 2021. From initial search (n=15,803), 2 researchers independently performed article selection. Conflicts were discussed until consensus additional researchers. Subsequent data extraction from selected was 4 researchers, an overarching guidance Risk bias assessment according Joanna Briggs Institute Critical Appraisal Checklists. Results A total 111 75 SSc analysis. Non-pharmacological identified included physical exercise (n=34), psychological support (n=21), dietary therapy nutrition (n=15), patient education self-management (n=14), photoprotection (n=5), medication adherence complementary alternative medicine (CAM) e.g., Chinese multidisciplinary care (n=4), phototherapy/laser modalities (n=4). Interventions hand, oral general shockwave (n=10), CAM (n=8), hand-bathing in paraffin manual osteopathic manipulative treatment hygiene (n=2), hyperbaric oxygen ozone (n=2) (n=2). Target systems within (in descending order) disease activity, health-related quality life (HRQoL), (iii) depression/anxiety, (iv) fatigue, (v) damage, (vi) inflammatory markers, (vii) stress, (viii) pain, (ix) body composition/anthropometry, (x) aerobic capacity. Intervention targets functional impairment hand mobility, skin microstomia, HRQoL, circulation Raynaud’s phenomena telangiectasias, ulcers, hygiene, digestion, depression/anxiety. Conclusion Physical frequently researched intervention both While therapy/nutrition investigated SLE, phototherapy common Patient advocated literature. HRQoL frequent domain diseases; while activity psychosocial emerged as important skin-related aspects constituted predominant Efficacy varied considerably across studies. Current evidence is limited overall small study populations, lack large RCTs. Table 1. Studies categorised design. Study design Meta-analysis RCTs 5 1 RCT (including long-term follow-up post-hoc analysis) 41 28 Non-randomised longitudinal controlled/cohort studies 7 Retrospective cohort study, cross-sectional case-control 16 Case series open pilot 21 37 Acknowledgements authors would like thank members alphabetical order family name) i.e., Helene Alexanderson, Laurent Arnaud, Oliver Distler, Andrea Domján, Els van den Ende, Kim Fligelstone, Agnes Kocher, Maddalena Larosa, Martin Lau, Alexandros Mitropoulos, Mwidimi Ndosi, Gunilla von Perner, Janet Poole, Anthony Redmond, Valentin Ritschl, Yvonne Sjöberg, Tillmann Uhlig, Cecília Varjú, Joke Vriezekolk, Elisabet Welin, Rene Westhovens, contribution formulation together IP, CG, TS CB. Disclosure Interests None declared