New 2019 ACR Recommendations for Vasculitis Treatment
ATLANTA – The American College of Rheumatology (ACR), in partnership with the Vasculitis Foundation (VF), is previewing new draft recommendations for the treatment of systemic vasculitis at the 2019 ACR/ARP Annual Meeting in Atlanta. The guidelines will be presented in multiple manuscripts that cover a wide variety of large-vessel, medium-vessel and ANCA-related conditions with recommendations on the use of diagnostic tests (including serologic, imaging, and biopsy studies), remission induction and maintenance therapies, treatment of refractory disease, and use of surgical interventions in systemic vasculitis. Once complete, it will be the first time the ACR has provided guidance on how to manage systemic vasculitis in rheumatology patients, and the first time the ACR and the VF have partnered on this type of effort.
“The diagnosis, treatment, and monitoring of these diseases can be challenging due to how rare they are,” said Dr. Sharon Chung, the lead investigator on the guideline development efforts. “While some treatment decisions can be made based on randomized clinical trials, many other decisions are guided by observational studies or clinical experience. To draft these guidelines, we developed relevant clinical questions and reviewed the evidence supporting potential interventions for these questions. We hope these recommendations will assist rheumatologists with managing some of the classic systemic vasculitis conditions they may encounter in clinical practice.”
Chung will discuss the draft recommendations at a press conference on Tuesday, Nov. 12, at 1:30 pm ET in Room B202 of the Georgia World Congress Center, and there will be three sessions during the meeting program where details of the draft recommendations will be shared:
- ANCA-Associated Vasculitis: How to Apply the New Guideline (Sunday, Nov. 10, 8:30-10 am)
- GCA, TAK & PAN: How to Apply the New Guideline (Monday, Nov. 11, 8:30-10 am)
- Kawasaki Disease Treatment: Old & New in 2019 (Monday, Nov. 11, 11-12 pm
Some of the draft recommendations that will be shared with attendees include:
- Conditional recommendations to use glucocorticoid-sparing therapies for the initial treatment of giant cell arteritis.
- Conditional recommendations to use vascular imaging to identify large-vessel involvement in patients newly diagnosed with giant cell arteritis.
- A conditional recommendation to use a reduced-dose glucocorticoid (e.g., prednisone) dosing strategy for the treatment of granulomatosis with polyangiitis and microscopic polyangiitis.
“Glucocorticoids have been a significant component of therapy for almost all of the systemic vasculitides for decades,” said Chung. “There is now increasing recognition of the toxicity of glucocorticoids, and thus we are recommending strategies to reduce their usage in patients with giant cell arteritis and ANCA-associated vasculitis and decrease their risk for these toxicities.”
The manuscripts containing the full list of recommendations and supporting evidence are currently under review and are anticipated to be published by Spring of 2020.
About the ACR/ARHP Annual Meeting
The ACR/ARP Annual Meeting is the premier meeting in rheumatology. With more than 450 sessions and thousands of abstracts, it offers a superior combination of basic science, clinical science, tech-med courses, career enhancement education and interactive discussions on improving patient care. For more information about the meeting, visit https://www.rheumatology.org/Annual-Meeting, or join the conversation on Twitter by following the official hashtag (#ACR19).
About the American College of Rheumatology
The American College of Rheumatology (ACR) is an international medical society representing over 8,500 rheumatologists and rheumatology health professionals with a mission to empower rheumatology professionals to excel in their specialty. In doing so, the ACR offers education, research, advocacy and practice management support to help its members continue their innovative work and provide quality patient care. Rheumatologists are experts in the diagnosis, management and treatment of more than 100 different types of arthritis and rheumatic diseases. For more information, visit www.rheumatology.org.
About the Vasculitis Foundation
Founded in 1986, the Vasculitis Foundation (VF) is the world’s leading nonprofit organization dedicated to earlier diagnosis, better treatments and improved quality of life for people living with vasculitis. A trusted resource for patients, family members, medical professionals and researchers, the VF offers disease education, raises awareness and funds research and fellowships. Learn more at www.vasculitisfoundation.org.