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2021 American College of Rheumatology/Vasculitis Foundation Guideline for the Management of Polyarteritis Nodosa.
- Source :
-
Arthritis & rheumatology (Hoboken, N.J.) [Arthritis Rheumatol] 2021 Aug; Vol. 73 (8), pp. 1384-1393. Date of Electronic Publication: 2021 Jul 08. - Publication Year :
- 2021
-
Abstract
- Objective: To provide evidence-based recommendations and expert guidance for the management of systemic polyarteritis nodosa (PAN).<br />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.<br />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.<br />Conclusion: These recommendations provide guidance regarding diagnostic strategies, use of pharmacologic agents, and imaging for patients with PAN.<br /> (© 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.)
- Subjects :
- Cyclophosphamide therapeutic use
Disease Management
Glucocorticoids therapeutic use
Humans
United States
Antirheumatic Agents therapeutic use
Evidence-Based Medicine standards
Polyarteritis Nodosa diagnosis
Polyarteritis Nodosa diagnostic imaging
Polyarteritis Nodosa drug therapy
Rheumatology standards
Subjects
Details
- Language :
- English
- ISSN :
- 2326-5205
- Volume :
- 73
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Arthritis & rheumatology (Hoboken, N.J.)
- Publication Type :
- Academic Journal
- Accession number :
- 34235883
- Full Text :
- https://doi.org/10.1002/art.41776