2021 American College of Rheumatology/Vasculitis Foundation Guideline for the Management of Antineutrophil Cytoplasmic Antibody-Associated Vasculitis.

Autor: Chung SA; University of California, San Francisco., Langford CA; Cleveland Clinic, Cleveland, Ohio., Maz M; University of Kansas Medical Center, Kansas City., Abril A; Mayo Clinic, Jacksonville, Florida., 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, 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. 1088-1105. Date of Electronic Publication: 2021 Jul 08.
DOI: 10.1002/acr.24634
Abstrakt: Objective: To provide evidence-based recommendations and expert guidance for the management of antineutrophil cytoplasmic antibody-associated vasculitis (AAV), including granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (EGPA).
Methods: Clinical questions regarding the treatment and management of AAV were developed in the population, intervention, comparator, and outcome (PICO) format (47 for GPA/MPA, 34 for EGPA). Systematic literature reviews were conducted for each PICO question. The Grading of Recommendations Assessment, Development and Evaluation methodology was used to assess the quality of evidence and formulate recommendations. Each recommendation required ≥70% consensus among the Voting Panel.
Results: We present 26 recommendations and 5 ungraded position statements for GPA/MPA, and 15 recommendations and 5 ungraded position statements for EGPA. This guideline provides recommendations for remission induction and maintenance therapy as well as adjunctive treatment strategies in GPA, MPA, and EGPA. These recommendations include the use of rituximab for remission induction and maintenance in severe GPA and MPA and the use of mepolizumab in nonsevere EGPA. All recommendations are conditional due in part to the lack of multiple randomized controlled trials and/or low-quality evidence supporting the recommendations.
Conclusion: This guideline presents the first recommendations endorsed by the American College of Rheumatology and the Vasculitis Foundation for the management of AAV and provides guidance to health care professionals on how to treat these diseases.
(© 2021, American College of Rheumatology.)
Databáze: MEDLINE
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