Systematic review and meta-analysis for 2023 clinical practice guidelines of the Japan Research Committee of the Ministry of Health, Labour, and Welfare for Intractable Vasculitis for the management of ANCA-associated vasculitis.

Autor:	Watanabe R; Department of Clinical Immunology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan., Oshima M; Department of Nephrology and Laboratory Medicine, Kanazawa University, Kanazawa, Japan., Nishioka N; Department of Preventive Services, Kyoto University School of Public Health, Kyoto, Japan., Sada KE; Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Graduate School of Medicine, Okayama University, Okayama, Japan.; Department of Clinical Epidemiology, Kochi Medical School, Kochi University, Nankoku, Japan., Nagasaka K; Department of Rheumatology, Ome Municipal General Hospital, Ome, Japan.; Department of Rheumatology and Medicine, Tokyo Medical and Dental University (TMDU), Tokyo, Japan., Akiyama M; Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan., Ando T; Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine, Tokyo, Japan., Higuchi T; Division of Multidisciplinary Management of Rheumatic Diseases, Tokyo Women's Medical University School of Medicine, Tokyo, Japan., Inoue Y; First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan., Kida T; Department of Inflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan., Mutoh T; Department of Rheumatology, Osaki Citizen Hospital, Osaki, Japan.; Department of Rheumatology, Tohoku University Hospital, Sendai, Japan., Nakabayashi A; Department of Rheumatology and Allergology, National Hospital Organization Osaka Minami Medical Center, Osaka, Japan., Onishi A; Department of Advanced Medicine for Rheumatic diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan., Sakai R; Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan., Waki D; Department of Endocrinology and Rheumatology, Kurashiki Central Hospital, Kurashiki, Japan., Yamada Y; Department of Nephrology, Shinshu University School of Medicine, Nagano, Japan., Yajima N; Division of Rheumatology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan., Tamura N; Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine, Tokyo, Japan., Kaname S; Department of Nephrology and Rheumatology, Kyorin University School of Medicine, Mitaka, Japan., Harigai M; Division of Rheumatology, Department of Internal Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.
Jazyk:	angličtina
Zdroj:	Modern rheumatology [Mod Rheumatol] 2023 Aug 25; Vol. 33 (5), pp. 982-989.
DOI:	10.1093/mr/roac114
Abstrakt:	Objectives: The objective of this study is to provide evidence for the revision of clinical practice guidelines for the management of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis by the Japan Research Committee for Intractable Vasculitis. Methods: PubMed, CENTRAL, and the Japan Medical Abstracts Society databases were searched for articles published between 2015 and 2020 to update the systematic review for existing clinical questions, while PubMed, CENTRAL, EMBASE, and the Japan Medical Abstracts Society were searched for articles published between 2000 and 2020 to conduct a systematic review for newly developed clinical questions. The certainty of evidence was assessed with the GRADE approach. Results: For remission induction, when used in conjunction with cyclophosphamide or rituximab, reduced-dose glucocorticoid lowered the risk of serious adverse events compared to standard-dose glucocorticoid. Avacopan improved sustained remission at 12 months compared to high-dose glucocorticoid. Addition of plasma exchange to remission induction therapy did not reduce the risk of death, end-stage kidney disease, or relapse. For remission maintenance, rituximab reduced the risk of relapse compared to azathioprine. Long-term rituximab or azathioprine reduced the risk of relapse compared to short-term rituximab or azathioprine, respectively. Conclusions: This systematic review provided evidence required to develop the 2023 clinical practice guideline for the management of ANCA-associated vasculitis. (© Japan College of Rheumatology 2022. Published by Oxford University Press.)
Databáze:	MEDLINE
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