@article{e2dce8ba55e24b65a96d009e72335353,
title = "2021 American College of Rheumatology/Vasculitis Foundation Guideline for the Management of Giant Cell Arteritis and Takayasu Arteritis",
abstract = "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.",
author = "Mehrdad Maz and Chung, {Sharon A.} and Andy Abril and Langford, {Carol A.} and Mark Gorelik and Gordon Guyatt and Amy M Archer 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. 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/acr.24632",
language = "English (US)",
volume = "73",
pages = "1071--1087",
journal = "Arthritis Care and Research",
issn = "2151-464X",
publisher = "John Wiley & Sons Inc.",
number = "8",
}