EULAR/ERA-EDTA recommendations for the management of ANCA-associated vasculitis

In this article, the 2009 European League Against Rheumatism (EULAR) recommendations for the management of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) have been updated. The 2009 recommendations were on the management of primary small and medium vessel vasculitis. The 2015...

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Vydané v:Annals of the rheumatic diseases Ročník 75; číslo 9; s. 1583 - 1594
Hlavní autori: Yates, M, Watts, R A, Bajema, I M, Cid, M C, Crestani, B, Hauser, T, Hellmich, B, Holle, J U, Laudien, M, Little, M A, Luqmani, R A, Mahr, A, Merkel, P A, Mills, J, Mooney, J, Segelmark, M, Tesar, V, Westman, K, Vaglio, A, Yalçındağ, N, Jayne, D R, Mukhtyar, C
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: England Elsevier Limited 01.09.2016
BMJ Publishing Group
Predmet:
Adeno-associated virus
Adrenocortical hormones
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - drug therapy
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - pathology
Antibodies
Apheresis
Biopsy - standards
Blood vessels
Clinical Medicine
Corticosteroides
Disease Management
Humans
Immunosuppressive Agents - therapeutic use
Klinisk medicin
Medical and Health Sciences
Medical protocols
Medicin och hälsovetenskap
Plasma Exchange
Protocols clínics
Recurrence
Remission (Medicine)
Remission Induction - methods
Retreatment - methods
Vasculitis
Vasos sanguinis
Disease Activity
Cyclophosphamide
Corticosteroids
Treatment
Systemic vasculitis
ISSN:0003-4967, 1468-2060, 1468-2060
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Popis
Shrnutí:In this article, the 2009 European League Against Rheumatism (EULAR) recommendations for the management of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) have been updated. The 2009 recommendations were on the management of primary small and medium vessel vasculitis. The 2015 update has been developed by an international task force representing EULAR, the European Renal Association and the European Vasculitis Society (EUVAS). The recommendations are based upon evidence from systematic literature reviews, as well as expert opinion where appropriate. The evidence presented was discussed and summarised by the experts in the course of a consensus-finding and voting process. Levels of evidence and grades of recommendations were derived and levels of agreement (strengths of recommendations) determined. In addition to the voting by the task force members, the relevance of the recommendations was assessed by an online voting survey among members of EUVAS. Fifteen recommendations were developed, covering general aspects, such as attaining remission and the need for shared decision making between clinicians and patients. More specific items relate to starting immunosuppressive therapy in combination with glucocorticoids to induce remission, followed by a period of remission maintenance; for remission induction in life-threatening or organ-threatening AAV, cyclophosphamide and rituximab are considered to have similar efficacy; plasma exchange which is recommended, where licensed, in the setting of rapidly progressive renal failure or severe diffuse pulmonary haemorrhage. These recommendations are intended for use by healthcare professionals, doctors in specialist training, medical students, pharmaceutical industries and drug regulatory organisations.
Bibliografia:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:0003-4967
1468-2060
1468-2060
DOI:10.1136/annrheumdis-2016-209133