{Reference Type}: Journal Article
{Title}: Pan American League of Associations for Rheumatology Guidelines for the treatment of ANCA-associated vasculitis.
{Author}: Magri SJ;Ugarte-Gil MF;Brance ML;Flores-Suárez LF;Fernández-Ávila DG;Scolnik M;Sato EI;de Souza AWS;Saldarriaga-Rivera LM;Babini AM;Zamora NV;Felquer MLA;Vergara F;Carlevaris L;Scarafia S;Guppy ERS;Unizony S; ;
{Journal}: Lancet Rheumatol
{Volume}: 5
{Issue}: 8
{Year}: 2023 Aug
{Factor}: 35.482
{DOI}: 10.1016/S2665-9913(23)00128-5
{Abstract}: Considerable variability exists in the way health-care providers treat patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis in Latin America. The most frequently used treatments for ANCA-associated vasculitis are cyclophosphamide and prolonged glucocorticoid tapers; however, randomised controlled trials conducted over the past 30 years have led to the development of several evidence-based treatment alternatives for these patients. Latin America faces socioeconomic challenges that affect access to care, and the use of certain costly medications with proven efficacy ANCA-associated vasculitis is often restricted. For these reasons, the Pan American League of Associations for Rheumatology developed the first ANCA-associated vasculitis treatment guidelines tailored for Latin America. A panel of local vasculitis experts generated clinically meaningful questions related to the treatment of ANCA-associated vasculitis using the Population, Intervention, Comparator, and Outcome (PICO) format. Following the Grading of Recommendations Assessment, Development, and Evaluation methodology, a team of methodologists conducted a systematic literature review. The panel of vasculitis experts voted on each PICO question and made recommendations, which required at least 70% agreement among the voting members. 21 recommendations and two expert opinion statements for the treatment of ANCA-associated vasculitis were developed, considering the current evidence and the socioeconomic characteristics of the region. These recommendations include guidance for the use of glucocorticoids, non-glucocorticoid immunosuppressants, and plasma exchange.