@article{42434bf3766b4ce7a6dc11ebbec892b6,
title = "2021 American College of Rheumatology/Vasculitis Foundation Guideline for the Management of Antineutrophil Cytoplasmic Antibody–Associated Vasculitis",
abstract = "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.",
author = "Chung, {Sharon A.} and Langford, {Carol A.} and Mehrdad Maz and Andy Abril and Mark Gorelik and Gordon Guyatt and Archer, {Amy M.} and Conn, {Doyt L.} and Full, {Kathy A.} and Grayson, {Peter C.} and Ibarra, {Maria F.} and Imundo, {Lisa F.} and Susan Kim and Merkel, {Peter A.} and Rhee, {Rennie L.} and Philip Seo and Stone, {John H.} and Sangeeta Sule and Sundel, {Robert P.} and Vitobaldi, {Omar I.} and Ann Warner and Kevin Byram and Dua, {Anisha B.} and Nedaa Husainat and James, {Karen E.} and Kalot, {Mohamad A.} and Lin, {Yih Chang} and Springer, {Jason M.} and Marat Turgunbaev and Alexandra Villa-Forte and Turner, {Amy S.} and Mustafa, {Reem A.}",
note = "Funding Information: We thank Anne M. Ferris, MBBS, Ora Gewurz-Singer, MD, Rula Hajj-Ali, MD, Eric Matteson, MD, MPH, Robert F. Spiera, MD, Linda Wagner-Weiner, MD, MS, and Kenneth J. Warrington, MD, for serving on the Expert Panel. We thank Antoine G. Sreih, MD, and Gary S. Hoffman, MD, MS, for their contributions during the early phases of this project as members of the Core Team. Dr. Hoffman{\textquoteright}s participation ended July 2018 due to personal reasons. Dr. Sreih{\textquoteright}s involvement ended in December 2018 when he became primarily employed by industry, which precluded his continued participation in this project. We thank Joyce Kullman (Vasculitis Foundation) for her assistance with recruitment for the Patient Panel. We thank the patients who (along with authors Kathy A. Full and Omar I. Vitobaldi) participated in the Patient Panel meeting: Jane Ascroft, Scott A. Brunton, Dedra DeMarco, Thomas Fitzpatrick, Jenn Gordon, Maria S. Mckay, Sandra Nye, Stephanie Sakson, and Ben Wilson. We thank Robin Arnold, Catherine E. Najem, MD, MSCE, and Amit Aakash Shah, MD, MPH, for their assistance with the literature review. We thank the ACR staff, including Ms Regina Parker, for assistance in organizing the face-to-face meeting and coordinating the administrative aspects of the project, and Ms Robin Lane for assistance in manuscript preparation. We thank Ms Janet Waters for help in developing the literature search strategy and performing the initial literature search, and Ms Janet Joyce for performing the update searches. Publisher Copyright: {\textcopyright} 2021, American College of Rheumatology",
year = "2021",
month = aug,
doi = "10.1002/acr.24634",
language = "English (US)",
volume = "73",
pages = "1088--1105",
journal = "Arthritis Care and Research",
issn = "2151-464X",
publisher = "John Wiley & Sons Inc.",
number = "8",
}