Repository logo
 
Publication

Systematic Literature Review Informing the 2018 Update of the EULAR Recommendation for the Management of Large Vessel Vasculitis: Focus on Giant Cell Arteritis

2019Journal article Open access
Simple item page
dc.contributor.authorMonti, S
dc.contributor.authorÁgueda, A
dc.contributor.authorLuqmani, R
dc.contributor.authorButtgereit, F
dc.contributor.authorCid, M
dc.contributor.authorDejaco, C
dc.contributor.authorMahr, A
dc.contributor.authorPonte, C
dc.contributor.authorSalvarani, C
dc.contributor.authorSchmidt, W
dc.contributor.authorHellmich, B
dc.date.accessioned2021-10-04T12:43:19Z
dc.date.available2021-10-04T12:43:19Z
dc.date.issued2019
dc.description.abstractObjectives: To analyse the current evidence for the management of large vessel vasculitis (LVV) to inform the 2018 update of the EULAR recommendations. Methods: Two systematic literature reviews (SLRs) dealing with diagnosis/monitoring and treatment strategies for LVV, respectively, were performed. Medline, Embase and Cochrane databases were searched from inception to 31 December 2017. Evidence on imaging was excluded as recently published in dedicated EULAR recommendations. This paper focuses on the data relevant to giant cell arteritis (GCA). Results: We identified 287 eligible articles (122 studies focused on diagnosis/monitoring, 165 on treatment). The implementation of a fast-track approach to diagnosis significantly lowers the risk of permanent visual loss compared with historical cohorts (level of evidence, LoE 2b). Reliable diagnostic or prognostic biomarkers for GCA are still not available (LoE 3b).The SLR confirms the efficacy of prompt initiation of glucocorticoids (GC). There is no high-quality evidence on the most appropriate starting dose, route of administration, tapering and duration of GC (LoE 4). Patients with GCA are at increased risk of dose-dependent GC-related adverse events (LoE 3b). The addition of methotrexate or tocilizumab reduces relapse rates and GC requirements (LoE 1b). There is no consistent evidence that initiating antiplatelet agents at diagnosis would prevent future ischaemic events (LoE 2a). There is little evidence to guide monitoring of patients with GCA. Conclusions: Results from two SLRs identified novel evidence on the management of GCA to guide the 2018 update of the EULAR recommendations on the management of LVV.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationRMD Open. 2019 Sep 16;5(2):e001003.pt_PT
dc.identifier.doi10.1136/rmdopen-2019-001003.pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3863
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherBMJpt_PT
dc.subjectHSM REUMpt_PT
dc.subjectAntibodies, Monoclonal, Humanized / administration & dosagept_PT
dc.subjectAntibodies, Monoclonal, Humanized / therapeutic usept_PT
dc.subjectAntirheumatic Agents / administration & dosagept_PT
dc.subjectAntirheumatic Agents / therapeutic usept_PT
dc.subjectFemalept_PT
dc.subjectMalept_PT
dc.subjectBiomarkers / metabolismpt_PT
dc.subjectBlindness / prevention & control*pt_PT
dc.subjectDrug Therapy, Combinationpt_PT
dc.subjectGiant Cell Arteritis / complications*pt_PT
dc.subjectGiant Cell Arteritis / diagnosispt_PT
dc.subjectGiant Cell Arteritis / drug therapy*pt_PT
dc.subjectGiant Cell Arteritis / metabolismpt_PT
dc.subjectGlucocorticoids / administration & dosagept_PT
dc.subjectGlucocorticoids / therapeutic usept_PT
dc.subjectHumanspt_PT
dc.subjectMethotrexate / administration & dosagept_PT
dc.subjectMethotrexate / therapeutic usept_PT
dc.subjectObservational Studies as Topicpt_PT
dc.subjectOutcome Assessment, Health Carept_PT
dc.subjectRandomized Controlled Trials as Topicpt_PT
dc.subjectRecurrencept_PT
dc.subjectRisk Managementpt_PT
dc.subjectSystemic Vasculitis / pathologypt_PT
dc.subjectTakayasu Arteritis / complicationspt_PT
dc.subjectTakayasu Arteritis / drug therapy*pt_PT
dc.titleSystematic Literature Review Informing the 2018 Update of the EULAR Recommendation for the Management of Large Vessel Vasculitis: Focus on Giant Cell Arteritispt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.titleRMD Openpt_PT
oaire.citation.volume5pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

Files

Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
RMD Open.pdf
Size:
495.29 KB
Format:
Adobe Portable Document Format
Download

Collections

REUM - Artigos