2021 American College of Rheumatology/Vasculitis Foundation Guideline for the Management of Giant Cell Arteritis and Takayasu Arteritis.

Autor: Maz M; University of Kansas Medical Center, Kansas City., Chung SA; University of California, San Francisco., Abril A; Mayo Clinic, Jacksonville, Florida., Langford CA; Cleveland Clinic Foundation, Cleveland, Ohio., Gorelik M; Columbia University, New York, New York., Guyatt G; McMaster University, Hamilton, Ontario, Canada., Archer AM; Northwestern University, Chicago, Illinois., Conn DL; Emory University, Atlanta, Georgia., Full KA; Springfield, Illinois., Grayson PC; National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland., Ibarra MF; Children's Mercy Hospital, Kansas City, Missouri., Imundo LF; Columbia University, New York, New York., Kim S; University of California, San Francisco., Merkel PA; University of Pennsylvania, Philadelphia., Rhee RL; University of Pennsylvania, Philadelphia., Seo P; Johns Hopkins University, Baltimore, Maryland., Stone JH; Massachusetts General Hospital, Boston., Sule S; Children's National Hospital, Washington, DC., Sundel RP; Boston Children's Hospital, Boston, Massachusetts., Vitobaldi OI; Chicago, Illinois., Warner A; Saint Luke's Health System, Kansas City, Missouri., Byram K; Vanderbilt University, Nashville, Tennessee., Dua AB; Northwestern University, Chicago, Illinois., Husainat N; SSM Health-St. Mary's Hospital, St. Louis, Missouri., James KE; University of Utah, Salt Lake City., Kalot MA; State University of New York at Buffalo., Lin YC; University of South Florida, Tampa., Springer JM; University of Kansas Medical Center, Kansas City., Turgunbaev M; American College of Rheumatology, Atlanta, Georgia., Villa-Forte A; Cleveland Clinic Foundation, Cleveland, Ohio., Turner AS; American College of Rheumatology, Atlanta, Georgia., Mustafa RA; University of Kansas Medical Center, Kansas City, and McMaster University, Hamilton, Ontario, Canada.
Jazyk: angličtina
Zdroj: Arthritis care & research [Arthritis Care Res (Hoboken)] 2021 Aug; Vol. 73 (8), pp. 1071-1087. Date of Electronic Publication: 2021 Jul 08.
DOI: 10.1002/acr.24632
Abstrakt: Objective: To provide evidence-based recommendations and expert guidance for the management of giant cell arteritis (GCA) and Takayasu arteritis (TAK) as exemplars of large vessel vasculitis.
Methods: Clinical questions regarding diagnostic testing, treatment, and management were developed in the population, intervention, comparator, and outcome (PICO) format for GCA and TAK (27 for GCA, 27 for TAK). Systematic literature reviews were conducted for each PICO question. The Grading of Recommendations Assessment, Development and Evaluation methodology was used to rate the quality of the evidence. Recommendations were developed by the Voting Panel, comprising adult and pediatric rheumatologists and patients. Each recommendation required ≥70% consensus among the Voting Panel.
Results: We present 22 recommendations and 2 ungraded position statements for GCA, and 20 recommendations and 1 ungraded position statement for TAK. These recommendations and statements address clinical questions relating to the use of diagnostic testing, including imaging, treatments, and surgical interventions in GCA and TAK. Recommendations for GCA include support for the use of glucocorticoid-sparing immunosuppressive agents and the use of imaging to identify large vessel involvement. Recommendations for TAK include the use of nonglucocorticoid immunosuppressive agents with glucocorticoids as initial therapy. There were only 2 strong recommendations; the remaining recommendations were conditional due to the low quality of evidence available for most PICO questions.
Conclusion: These recommendations provide guidance regarding the evaluation and management of patients with GCA and TAK, including diagnostic strategies, use of pharmacologic agents, and surgical interventions.
(© 2021 American College of Rheumatology. This article has been contributed to by US Government employees and their work is in the public domain in the USA.)
Databáze: MEDLINE
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