ACR/VF Guidelines Conference Videos

General Session One: Part 1
Introducing the 2021 ACR/VF Vasculitis Clinical Practice Guidelines

Speaker:
Sharon A. Chung, MD, MAS
Director, Vasculitis Clinic, UCSF
San Francisco, California

General Session One: Part 2
Introducing the 2021 ACR/VF Vasculitis Clinical Practice Guidelines: Q&A with Dr. Sharon Chung

General Session Two: Disseminating the Guidelines to Healthcare Professionals

Speaker:
Carol A. Langford, MD, MHS, FACP
Director, Center for Vasculitis Care and
Research, Cleveland Clinic, Cleveland, Ohio

2021 Virtual ACR/VF Patient Treatment Conference Breakout Sessions

Giant Cell Arteritis (GCA) Breakout Session

Historical Accounts of GCA	4:02
2012 Revised International Chapel Hill Consensus Conference (CHCC2012) Nomenclature of Vasculitides	5:28
CHCC2012 definition of GCA	6:41
Therapy Definitions	8:56
GCA Case: Initial Presentation	11:09
Diagnostic Testing Recommendations	14:17
Medical Management Recommendations	26:29
Trial of Tocilizumab in GCA	31:44
GCA Case: New Visual Symptoms	34:18
Surgical Intervention Recommendations	38:00
GCA Case: The Challenge of Inflammatory Markers	40:47
Clinical / Laboratory Monitoring Recommendations	41:43
GCA Case: Relapse	42:26
Medical Management Recommendations: Add Statins?	46:00
GCA Case: Long Term Monitoring	48:12
Duration of Therapy Upgraded Position Statement	49:50

Speaker:
Mehrdad Maz, MD
Director, Allergy, Clinical Immunology
and Rheumatology, Kansas University,
Kansas City, Kansas

Moderator:
Rennie Rhee, MD,
University of Pennsylvania Vasculitis Center,
Philadelphia, Pennsylvania

Polyarteritis Nodosa (PAN) Breakout Session

Polyarteritis Nodosa (PAN) Quick Facts	2:41
Important Considerations for the Recommendations	6:40
Guideline Methods	7:39
PAN Case One	9:56
Diagnostic Challenges: The Skin Biopsy	10:32
Skin Biopsy: Deep vs. Punch	11:45
Diagnostic Challenges: The Nerve Biopsy	13:24
Abdominal Vascular Imaging	17:24
Treatment Phases	20:15
Treatment After Remission	22:29
Treatment with Physical Therapy	24:59
Q&A: Do these guidelines cover systemic and cutaneous PAN?	30:40
Q&A: Do the recommendations cover the use of Rituximab with PAN?	31:29
Q&A: Was it a challenge to find clinical study information on PAN to use in considering recommendations?	35:43
Q&A: What is recommendation if patient fails Cellcept and is having a liver problem? Is Rituximab an option?	38:49
Q&A: What do recommendations say about how long a patient has to remain on immunosuppressants or steroids once he/she is in remission?	42:27
Q&A: Could you share the 2-3 most important recommendations for PAN?	45:16
Q&A: Do the recommendations address the issue of using imaging to monitor long-term damage caused to the arteries.	48:32

Speaker:
Jason A. Springer, MD, MS
Co-Director, Vanderbilt Vasculitis Center,
Nashville, Tennessee

Moderator:
Yih Chang Lin, MD
University of South Florida Vasculitis Center
Tampa, Florida

Granulomatosis with Polyangiitis (GPA) and Microscopic Polyangiitis (MPA) Breakout Session

Overview of GPA and MPA	1:56
A Patient Case	4:07
General Treatment Strategy: active, severe GPA/MPA	5:48
Question: What medication should this patient receive for remission induction?	6:59
Reduced vs. Standard Dosing Regimen	10:16
What About Other Remission Maintenance Agents?	15:14
Preferences for Remission Induction and Maintenance Therapy in Severe GPA/MPA	16:29
What Therapy If Relapse Occurs?	25:14
What About ANCA Titers?	28:06
What About Combination Drive?	35:35
Other Interventions About Sinus Symptoms?	37:41
Avacopan.	39:44
Q: Could you talk more about ANCA-titers, and B-Cell Monitoring?	44:51
Q: What research or knowledge gaps did you find related to GPA and MPA?	51:23
Q: Do the ACR/VF Guidelines address biosimilars?	53:42
Q: Any comments or concerns about the COVID vaccines triggering an autoimmune response?	54:54

Speaker:
Sharon A. Chung, MD, MAS Director, Vasculitis
Clinic, UCSF
San Francisco, California

Moderator:
Kevin W. Byram, MD
Co-Director, Vanderbilt Vasculitis Clinic,
Nashville, Tennessee

Eosinophilic Granulomatosis with Polyangiitis (EGPA) Breakout Session

Overview of EGPA	2:10
ACR / VF Guideline for the Management of EGPA	3:25
Recommendations on the Treatment of EGPA	5:03
Q&A: Is being ANCA negative a good thing, or a bad thing?	19:44
Q&A: Could you comment on what the guidelines say about Leukotriene inhibitors?	22:24
Q&A: What is the role for Avocopan in EGPA?	24:00
Q&A: Can you comment on the recommendation about having an echocardiogram at the time of diagnosis?	27:48
Q&A: Do the guidelines take a stand on the use of Mepolizumab? Is this the drug of choice?	30:59
Q&A: Are there still patients for whom you would recommend the use of Cyclophosphamide over Rituximab?	32:47
Q&A: Do you have a favorite guideline?	35:10
Q&A: Do you think there are particular guidelines that will be ripe of review in the future?	37:25
Q&A: Do you have an opinion on the role of IVIG and whether it’s indicated, or contradicted in EGPA?	39:08
Q&A: Can you comment on the role of pneumocystis prophylaxis?
Q&A: What do you see as the most urgent clinical need for EGPA?	45:14
Q&A: If a patient has EGPA is there any concern that someone else in their family could also get it, or a form of vasculitis?	46:14
Q&A: Do all flares in EGPA associate with increases in eosinophils count?	49:23

Speaker:
Carol A. Langford, MD, MHS, FACP
Director, Center for Vasculitis Care and
Research, Cleveland Clinic, Cleveland, Ohio

Moderator:
Phil Seo, MD
Director, Johns Hopkins Vasculitis Center,
Baltimore, Maryland

Takayasu Arteritis (TAK)

What is Takayasu Arteritis (TAK)?	0:24
TAK ACR Classification Criteria.	1:47
What makes TAK difficult?	2:30
A TAK Case Presentation.	3:18
Using non-evasive imagine over cathedar-based dye angiography as assessment tool.	4:07
What to do in cases of active, severe takayasu arteritis.	4:57
Non-GC Immunosuppressive Agents.	5:39
Overview of how to treat active Takayasu Arteritis.	7:01
Refractory disease–Biologics.	8:02
Monitoring Takayasu Arteritis–Clinical.	9:26
Monitoring Takayasu Arteritis–Labs	10:17
Adding inflammatory markers.	10:19
Recommend regularly scheduled non-invasive imaging.	10:57
Goal: Steroids =0.	12:26
Surgical intervention.	15:45
Refractory disease and surgical intervention.	16:36
Special considerations: TAK and pregnancy.	19:47
Key points summary.	21:17

Anisha Dua, MD, MPH
Director, Northwestern Vasculitis Center, Chicago, Illinois

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