当前位置： SCI文献检索 > ANNALS OF THE RHEUMATIC DISEASES期刊下所有文献 > 2018 Update of the EULAR recommendations for the management of large vessel vasculitis.

2018 Update of the EULAR recommendations for the management of large vessel vasculitis.

Abstract：

BACKGROUND:Since the publication of the European League Against Rheumatism (EULAR) recommendations for the management of large vessel vasculitis (LVV) in 2009, several relevant randomised clinical trials and cohort analyses have been published, which have the potential to change clinical care and therefore supporting the need to update the original recommendations. METHODS:Using EULAR standardised operating procedures for EULAR-endorsed recommendations, the EULAR task force undertook a systematic literature review and sought opinion from 20 experts from 13 countries. We modified existing recommendations and created new recommendations. RESULTS:Three overarching principles and 10 recommendations were formulated. We recommend that a suspected diagnosis of LVV should be confirmed by imaging or histology. High dose glucocorticoid therapy (40-60 mg/day prednisone-equivalent) should be initiated immediately for induction of remission in active giant cell arteritis (GCA) or Takayasu arteritis (TAK). We recommend adjunctive therapy in selected patients with GCA (refractory or relapsing disease, presence of an increased risk for glucocorticoid-related adverse events or complications) using tocilizumab. Methotrexate may be used as an alternative. Non-biological glucocorticoid-sparing agents should be given in combination with glucocorticoids in all patients with TAK and biological agents may be used in refractory or relapsing patients. We no longer recommend the routine use of antiplatelet or anticoagulant therapy for treatment of LVV unless it is indicated for other reasons. CONCLUSIONS:We have updated the recommendations for the management of LVV to facilitate the translation of current scientific evidence and expert opinion into better management and improved outcome of patients in clinical practice.

journal_name

Ann Rheum Dis

journal_title

Annals of the rheumatic diseases

authors

Hellmich B,Agueda A,Monti S,Buttgereit F,de Boysson H,Brouwer E,Cassie R,Cid MC,Dasgupta B,Dejaco C,Hatemi G,Hollinger N,Mahr A,Mollan SP,Mukhtyar C,Ponte C,Salvarani C,Sivakumar R,Tian X,Tomasson G,Turesson C,S

doi

10.1136/annrheumdis-2019-215672

subject

Has Abstract

pub_date

2020-01-01 00:00:00

pages

19-30

issue

eissn

0003-4967

issn

1468-2060

pii

annrheumdis-2019-215672

journal_volume

pub_type

共识发展会议,杂志文章,实务指引

在线工具

2018 Update of the EULAR recommendations for the management of large vessel vasculitis.