gms | German Medical Science

Deutscher Rheumatologiekongress 2022, 50. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 36. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), 32. Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR)

31.08. - 03.09.2022, Berlin

A systematic literature review informing the 2022 update of the EULAR recommendations for the management of ANCA-associated vasculitis

Meeting Abstract

  • Jan Schirmer - Klinik für Innere Medizin I, Sektion Rheumatologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel
  • Beatriz Sánchez-Álamo - Skåne University Hospital, Lund University, Lund
  • Sara Monti - Rheumatology, Fondazione IRCCS Policlinico S. Matteo, University of Pavia, Pavia
  • Gunnar Tomasson - Centre for Rheumatology Research, University Hospital Reykjavik, Reykjavik
  • David Jayne - University of Cambridge, Cambridge
  • Bernhard Hellmich - Medius Kliniken, Universität Tübingen, Tübingen

Deutsche Gesellschaft für Rheumatologie. Deutsche Gesellschaft für Orthopädische Rheumatologie. Gesellschaft für Kinder- und Jugendrheumatologie. Deutscher Rheumatologiekongress 2022, 50. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 36. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), 32. Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR). Berlin, 31.08.-03.09.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocVK.15

doi: 10.3205/22dgrh193, urn:nbn:de:0183-22dgrh1934

Veröffentlicht: 31. August 2022

© 2022 Schirmer et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Background/Objectives: Since the publication of the 2016 European Alliance of Associations for Rheumatology (EULAR) recommendations for the management of ANCA-associated vasculitis (AAV) [1], the publication of several high-impact randomized-controlled studies improved the standard of care of AAV. The aim of this systematic review was to collect evidence supporting the 2022 update the EULAR recommendations for the management of AAV.

Methods: The recommendations were developed based on an evidence-based approach as outlined in the EULAR standardized operating procedures (SOP) [2]. Areas of interest were adopted from the 2016 recommendations [1] and updated by identifying additional topics through a Delphi process. Key questions were framed in the PICO (Population, Intervention, Comparator, Outcome) format and 3 search strategies (for treatment, diagnostic procedures and aspects of general management) were created based on the PICO questions. PubMed, Embase and the Cochrane Library databases were searched. After deduplication publications were sorted by title and abstract first and subsequentally assessed in full text if eligible after title/abstract screening. The data were extracted from included articles according to PICO questions and collected in evidence tables.

Results: Based on the results of the Delphi, apart from domains of general management, 11 topics related to therapeutic interventions and 3 topics related to diagnostic and follow-up were identified that were transformed into PICO questions.

After deduplication 3,510, 4,130 and 4,205 abstracts were identified for the areas of treatment, diagnosis/follow-up and general management, respectively.

Key findings discovered by the SLR include studies on biopsies and ANCA testing, RCTs covering remission induction and maintenance treatment, the role of plasma exchange, steroid sparing protocols including the use of avacopan, duration of remission maintenance treatment with conventional immunosuppressives and the role of mepolizumab and other treatment regimens in Eosinophilic Granulomatosis with Polyangiitis.

The SLR was still ongoing at the time this abstract has been written and results of the SLR will be presented at the meeting.

Conclusion: This SLR identified recent developments affecting key areas of AAV treatment, that provide systematic evidence to inform the 2022 update of the EULAR recommendations for the management of AAV.

Funding: The project is funded by EULAR.


References

1.
Yates M, Watts RA, Bajema IM, Cid MC, Crestani B, Hauser T, Hellmich B, Holle JU, Laudien M, Little MA, Luqmani RA, Mahr A, Merkel PA, Mills J, Mooney J, Segelmark M, Tesar V, Westman K, Vaglio A, Yalçındağ N, Jayne DR, Mukhtyar C. EULAR/ERA-EDTA recommendations for the management of ANCA-associated vasculitis. Ann Rheum Dis. 2016 Sep;75(9):1583-94. DOI: 10.1136/annrheumdis-2016-209133 Externer Link
2.
van der Heijde D, Aletaha D, Carmona L, Edwards CJ, Kvien TK, Kouloumas M, Machado P, Oliver S, de Wit M, Dougados M. 2014 Update of the EULAR standardised operating procedures for EULAR-endorsed recommendations. Ann Rheum Dis. 2015 Jan;74(1):8-13. DOI: 10.1136/annrheumdis-2014-206350 Externer Link