A Framework on Developing an Integrative Medicine Clinical Practice Guideline (CPG) for Systemic Lupus erythematosus (SLE) with Comorbidities Management in Hong Kong

Author(s): Yuanyuan Chen, Philip Hei Li, Cheng Zhang, Ning Wang, Yibin Feng, Che-Shing Lau

Background: Systemic Lupus erythematosus (SLE) is a heterogeneous autoimmune disease that affects multiple organs. In most patients with SLE, the comorbidity manifests within three years of initial diagnosis. In Hong Kong, SLE with comorbidities significantly affect patients' quality of life and contributes to mortality. Due to the complexity of comorbidities, clinicians require comprehensive suggestions across disciplines. An integrative medicine clinical practice guideline (CPG) must be developed for the management of SLE with comorbidities. Therefore, this framework is designed to address multimorbidity in SLE patients.

Methods & Results: The framework is based on the steps of developing CPGs outlined in the WHO handbook for guideline development, Appraisal of Guidelines for Research and Evaluation II Instrument, Guideline International Network and Reporting Items for Practice Guidelines in Healthcare. The design of CPG for SLE includes nine steps as the followings: topic scoping, establishing a guideline development group, formulating key clinical questions, selecting and rating outcomes, conducting a systematic review of the evidence, assessing the quality of evidence, developing recommendations, drafting and publishing the guideline document, and updating are conducted.

Conclusion: This CPG represents a significant advancement in establishing guidelines for multimorbidity in SLE. It will provide recommendations for the management of comorbidities in SLE. To update and adjust recommendations, further studies with large-scale clinical trials are necessary for the future.