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Management of antineutrophil cytoplasmic antibody–associated vasculitis with glomerulonephritis as proposed by the ACR 2021, EULAR 2022 and KDIGO 2021 guidelines/recommendations

Moura, Marta Casal ; Gauckler, Philipp ; Anders, Hans Joachim ; Bruchfeld, Annette ; Fernandez-Juarez, Gema M. ; Floege, Jürgen ; Frangou, Eleni ; Goumenos, Dimitrios ; Segelmark, Marten LU and Turkmen, Kultigin , et al. (2023) In Nephrology Dialysis Transplantation 38(11). p.2637-2651
Abstract

Updated guidelines on the management of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) were released in 2021 by the American College of Rheumatology jointly with the Vasculitis Foundation and, subsequently, in 2022 by the European Alliance of Associations for Rheumatology. In addition, in 2021, the Kidney Disease: Improving Global Outcomes had released updated recommendations on the treatment of AAV with glomerulonephritis (AAV-GN). Kidney involvement is particularly relevant in microscopic polyangiitis and granulomatosis with polyangiitis, but is less frequent in eosinophilic granulomatosis with polyangiitis. The management of AAV-GN has been a focus for drug development and change over the past 10 years.... (More)

Updated guidelines on the management of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) were released in 2021 by the American College of Rheumatology jointly with the Vasculitis Foundation and, subsequently, in 2022 by the European Alliance of Associations for Rheumatology. In addition, in 2021, the Kidney Disease: Improving Global Outcomes had released updated recommendations on the treatment of AAV with glomerulonephritis (AAV-GN). Kidney involvement is particularly relevant in microscopic polyangiitis and granulomatosis with polyangiitis, but is less frequent in eosinophilic granulomatosis with polyangiitis. The management of AAV-GN has been a focus for drug development and change over the past 10 years. Avoidance of progression to end-stage kidney disease (ESKD) or kidney failure is one of the main unmet needs in the management of AAV, with ESKD having a major impact on morbidity, health costs and mortality risk. Relevant changes in AAV-GN management are related to remission-induction treatment of patients with severe kidney disease, the use of glucocorticoids and avacopan, and remission-maintenance treatment. All the documents provide guidance in accordance with the evidence-based standard of care available at the time of their release. With our work we aim to (i) show the progress made and identify the differences between guidelines and recommendations, (ii) discuss the supporting rationale for those, and (iii) identify gaps in knowledge that could benefit from additional research and should be revised in subsequent updates.

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type
Contribution to journal
publication status
published
subject
keywords
ANCA-associated vasculitis, glomerulonephritis, granulomatosis with polyangiitis, guidelines, microscopic polyangiitis
in
Nephrology Dialysis Transplantation
volume
38
issue
11
pages
15 pages
publisher
Oxford University Press
external identifiers
  • scopus:85171743428
  • pmid:37164940
ISSN
0931-0509
DOI
10.1093/ndt/gfad090
language
English
LU publication?
yes
id
1fe423c5-67db-4eed-8398-711ea27585d8
date added to LUP
2024-01-15 11:07:59
date last changed
2024-06-11 03:47:50
@article{1fe423c5-67db-4eed-8398-711ea27585d8,
  abstract     = {{<p>Updated guidelines on the management of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) were released in 2021 by the American College of Rheumatology jointly with the Vasculitis Foundation and, subsequently, in 2022 by the European Alliance of Associations for Rheumatology. In addition, in 2021, the Kidney Disease: Improving Global Outcomes had released updated recommendations on the treatment of AAV with glomerulonephritis (AAV-GN). Kidney involvement is particularly relevant in microscopic polyangiitis and granulomatosis with polyangiitis, but is less frequent in eosinophilic granulomatosis with polyangiitis. The management of AAV-GN has been a focus for drug development and change over the past 10 years. Avoidance of progression to end-stage kidney disease (ESKD) or kidney failure is one of the main unmet needs in the management of AAV, with ESKD having a major impact on morbidity, health costs and mortality risk. Relevant changes in AAV-GN management are related to remission-induction treatment of patients with severe kidney disease, the use of glucocorticoids and avacopan, and remission-maintenance treatment. All the documents provide guidance in accordance with the evidence-based standard of care available at the time of their release. With our work we aim to (i) show the progress made and identify the differences between guidelines and recommendations, (ii) discuss the supporting rationale for those, and (iii) identify gaps in knowledge that could benefit from additional research and should be revised in subsequent updates.</p>}},
  author       = {{Moura, Marta Casal and Gauckler, Philipp and Anders, Hans Joachim and Bruchfeld, Annette and Fernandez-Juarez, Gema M. and Floege, Jürgen and Frangou, Eleni and Goumenos, Dimitrios and Segelmark, Marten and Turkmen, Kultigin and van Kooten, Cees and Tesar, Vladimir and Geetha, Duvuru and Fervenza, Fernando C. and Jayne, David R.W. and Stevens, Kate I. and Kronbichler, Andreas}},
  issn         = {{0931-0509}},
  keywords     = {{ANCA-associated vasculitis; glomerulonephritis; granulomatosis with polyangiitis; guidelines; microscopic polyangiitis}},
  language     = {{eng}},
  number       = {{11}},
  pages        = {{2637--2651}},
  publisher    = {{Oxford University Press}},
  series       = {{Nephrology Dialysis Transplantation}},
  title        = {{Management of antineutrophil cytoplasmic antibody–associated vasculitis with glomerulonephritis as proposed by the ACR 2021, EULAR 2022 and KDIGO 2021 guidelines/recommendations}},
  url          = {{http://dx.doi.org/10.1093/ndt/gfad090}},
  doi          = {{10.1093/ndt/gfad090}},
  volume       = {{38}},
  year         = {{2023}},
}