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

被引：4

作者：

Maz, Mehrdad ^{[1
]}

Chung, Sharon A. ^{[2
]}

Abril, Andy ^{[3
]}

Langford, Carol A. ^{[4
]}

Gorelik, Mark ^{[5
]}

Guyatt, Gordon ^{[6
]}

Archer, Amy M. ^{[7
]}

Conn, Doyt L. ^{[8
]}

Full, Kathy A.

Grayson, Peter C. ^{[9
]}

Ibarra, Maria F. ^{[10
]}

Imundo, Lisa F. ^{[5
]}

Kim, Susan ^{[2
]}

Merkel, Peter A. ^{[11
]}

Rhee, Rennie L. ^{[11
]}

Seo, Philip ^{[12
]}

Stone, John H. ^{[13
]}

Sule, Sangeeta ^{[14
]}

Sundel, Robert P. ^{[15
]}

Vitobaldi, Omar I. ^{[16
]}

Warner, Ann ^{[17
]}

Byram, Kevin ^{[18
]}

Dua, Anisha B. ^{[7
]}

Husainat, Nedaa ^{[19
]}

James, Karen E. ^{[20
]}

Kalot, Mohamad A. ^{[21
]}

Lin, Yih Chang ^{[22
]}

Springer, Jason M. ^{[1
]}

Turgunbaev, Marat ^{[23
]}

Villa-Forte, Alexandra ^{[4
]}

Turner, Amy S. ^{[23
]}

Mustafa, Reem A. ^{[24
,25
]}

机构：

[1] Univ Kansas, Med Ctr, Kansas City, KS 66103 USA

[2] Univ Calif San Francisco, San Francisco, CA 94143 USA

[3] Mayo Clin, Jacksonville, FL 32224 USA

[4] Cleveland Clin Fdn, 9500 Euclid Ave, Cleveland, OH 44195 USA

[5] Columbia Univ, New York, NY USA

[6] McMaster Univ, Hamilton, ON, Canada

[7] Northwestern Univ, Chicago, IL 60611 USA

[8] Emory Univ, Atlanta, GA 30322 USA

[9] NIAMSD, NIH, Bethesda, MD 20892 USA

[10] Mercy Hosp, Kansas City, KS USA

[11] Univ Penn, Philadelphia, PA 19104 USA

[12] Johns Hopkins Univ, Baltimore, MD USA

[13] Massachusetts Gen Hosp, Boston, MA 02114 USA

[14] Natl Childrens Hosp, Washington, DC USA

[15] Boston Childrens Hosp, Boston, MA USA

[16] MSEE, Chicago, IL USA

[17] St Lukes Hlth Syst, Kansas City, KS USA

[18] Vanderbilt Univ, 221 Kirkland Hall, Nashville, TN 37235 USA

[19] Marys Hosp, St Louis, MO USA

[20] Univ Utah, Salt Lake City, UT USA

[21] SUNY Buffalo, Buffalo, NY USA

[22] Univ S Florida, Tampa, FL 33620 USA

[23] Amer Coll Rheumatol, 60 Execut Pk S,Suite 150, Atlanta, GA 30329 USA

[24] Univ Kansas, Med Ctr, Kansas City, KS 66103 USA

[25] McMaster Univ, Hamilton, ON, Canada

来源：

ARTHRITIS CARE & RESEARCH | 2021年 / 73卷 / 08期

关键词：

F-18-FLUORODEOXYGLUCOSE-POSITRON EMISSION TOMOGRAPHY; SEVERE ISCHEMIC COMPLICATIONS; PLACEBO-CONTROLLED TRIAL; LARGE-VESSEL VASCULITIS; LONG-TERM OUTCOMES; DOUBLE-BLIND TRIAL; ENDOVASCULAR TREATMENT; FOLLOW-UP; CORTICOSTEROID TREATMENT; POLYMYALGIA-RHEUMATICA;

D O I：

10.1002/acr.24632

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页码：1071 / 1087

页数：17

共 105 条

[1] HOW DOES PREVIOUS CORTICOSTEROID TREATMENT AFFECT THE BIOPSY FINDINGS IN GIANT-CELL (TEMPORAL) ARTERITIS [J].