@article{a64b60658298428b836689fbd5dfb1b3,
title = "2021 American College of Rheumatology/Vasculitis Foundation Guideline for the Management of Polyarteritis Nodosa",
abstract = "Objective: To provide evidence-based recommendations and expert guidance for the management of systemic polyarteritis nodosa (PAN). Methods: Twenty-one clinical questions regarding diagnostic testing, treatment, and management were developed in the population, intervention, comparator, and outcome (PICO) format for systemic, non–hepatitis B–related PAN. 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 16 recommendations and 1 ungraded position statement for PAN. Most recommendations were graded as conditional due to the paucity of evidence. These recommendations support early treatment of severe PAN with cyclophosphamide and glucocorticoids, limiting toxicity through minimizing long-term exposure to both treatments, and the use of imaging and tissue biopsy for disease diagnosis. These recommendations endorse minimizing risk to the patient by using established therapy at disease onset and identify new areas where adjunctive therapy may be warranted. Conclusion: These recommendations provide guidance regarding diagnostic strategies, use of pharmacologic agents, and imaging for patients with PAN.",
author = "Chung, {Sharon A.} and Mark Gorelik and Langford, {Carol A.} and Mehrdad Maz and Andy Abril 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 Mohamad Kalot and Yih Chang Lin and Springer, {Jason M.} and Marat Turgunbaev and Alexandra Villa-Forte and Turner, {Amy S.} and Reem A Mustafa",
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. This article has been contributed to by US Government employees and their work is in the public domain in the USA.",
year = "2021",
month = aug,
doi = "10.1002/art.41776",
language = "English (US)",
volume = "73",
pages = "1384--1393",
journal = "Arthritis and Rheumatology",
issn = "2326-5191",
publisher = "John Wiley and Sons Ltd",
number = "8",
}