{
  "abstract": "Introduction Secondary Raynaud’s phenomenon affects the majority of patients with Systemic Sclerosis (SSc). These patients frequently develop painful digital ulcers with significant impact on quality of life, potential for serious infections, and risk of amputation as a result of critical ischemia and gangrene. In a recent survey, Raynaud’s phenomenon was brought forward by SSc patients as a symptom deserving more attention during hospital visits (ref). However, while a primary care guideline for primary Raynaud’s phenomenon exists in the Netherlands, no standardized clinical practice guideline has been available for managing secondary Raynaud’s phenomenon in secondary and tertiary care settings. Since patients in the Netherlands initially tend to present to varying medical specialists, resulting in heterogeneous treatment approaches dependent on individual clinician’s experience.Material and Methods A multidisciplinary guideline development group has been established, uniquely comprising specialists from rheumatology, internal medicine-vascular medicine, internal medicine-clinical immunology, plastic surgery, vascular surgery, and nurse practitioners, alongside two patient representatives from the National Association for Lupus, APS, Scleroderma and MCTD.Results The comprehensive guideline addresses evidence-based recommendations for both pharmacological and non-pharmacological interventions, wound management, surgical treatment indications, and optimal care organization models. A sounding board group comprising a hospital pharmacist, general practitioner, dermatologist, thoracic surgeon, vascular internist, and rheumatologist will review the concept guideline version. This multidisciplinary approach ensures integration of multiple medical specialities, nursing expertise, and crucially, patient perspectives throughout the development process. Following a broader comment phase, the guideline will undergo formal authorization by participating medical societies and several stakeholders in the field.Conclusions This evidence-based guideline aims to standardize and optimize treatment of secondary Raynaud’s phenomenon and digital ulcers in Dutch secondary and tertiary care. The unique multidisciplinary development process, including patient representatives and nurse practitioners alongside multiple medical specialities, ensures comprehensive and patient-centered recommendations. Upon authorization, the guideline will be published on www.richtlijnendatabase.nl early 2026, providing healthcare professionals with standardized, evidence-based treatment advise for this challenging condition.",
  "authors": [
    {
      "affiliations": [
        "University Medical Center Groningen, Div of Vascular Medicine, Department of Internal Medicine, University of Groningen, Groningen, The Netherlands"
      ],
      "name": "Amaal Eman Abdule"
    },
    {
      "affiliations": [
        "University of Groningen, University Medical Center Groningen, Department of Rheumatology and Clinical Immunology, Groningen, The Netherlands"
      ],
      "name": "Anniek Van Roon"
    },
    {
      "affiliations": [
        "Maasstad Hospital, Department of Rheumatology and Clinical Immunology, Rotterdam, The Netherlands"
      ],
      "name": "Femke Bonte-Mineur"
    },
    {
      "affiliations": [
        "Erasmus Medical Center, Department of Immunology, Rotterdam, The Netherlands"
      ],
      "name": "Zana Brkic"
    },
    {
      "affiliations": [
        "NVLE, Dutch Association for people living with Lupus, APS, Scleroderma and MCTD, Utrecht, The Netherlands"
      ],
      "name": "Jamy Pullen"
    },
    {
      "affiliations": [
        "University Medical Center Groningen, Department of Plastic Surgery, University of Groningen, Groningen, The Netherlands"
      ],
      "name": "Mike Ruetterman"
    },
    {
      "affiliations": [
        "University Medical Center Groningen, Department of Surgery, div. of Vascular Surgery, University of Groningen, Groningen, The Netherlands"
      ],
      "name": "Ben Saleem"
    },
    {
      "affiliations": [
        "University Medical Centre Utrecht, Department of Rheumatology & Clinical Immunology, Utrecht, The Netherlands"
      ],
      "name": "Sanne Van Schaik-Mast"
    },
    {
      "affiliations": [
        "HagaZiekenhuis, Department of Rheumatology, The Hague, The Netherlands"
      ],
      "name": "Anne Schouffoer"
    },
    {
      "affiliations": [
        "PROVA, Varsseveld, The Netherlands"
      ],
      "name": "Rita Schriemer"
    },
    {
      "affiliations": [
        "University Medical Centre Utrecht, Department of Rheumatology & Clinical Immunology, Utrecht, The Netherlands"
      ],
      "name": "Julia Spierings"
    },
    {
      "affiliations": [
        "OLVG, Department of Internal Medicine, Amsterdam, The Netherlands"
      ],
      "name": "Sanne Van Wissen"
    },
    {
      "affiliations": [
        "PROVA, Varsseveld, The Netherlands"
      ],
      "name": "Mariska Tuut"
    },
    {
      "affiliations": [
        "University Medical Center Groningen, Div of Vascular Medicine, Department of Internal Medicine, University of Groningen, Groningen, The Netherlands"
      ],
      "name": "Douwe Johannes Mulder"
    }
  ],
  "title": "P.279 Development of a multidisciplinary dutch clinical practice guideline for the treatment of secondary raynaud’s phenomenon and related digital ulcers in secondary and tertiary care",
  "uid": "5471af6c-2499-51ca-9ccf-ddc4d754ef6d"
}