巨细胞动脉炎的管理：法国大血管血管炎研究组（GEFA）的建议。
Management of giant cell arteritis: Recommendations of the French Study Group for Large Vessel Vasculitis (GEFA).
作者信息
Bienvenu B, Ly K H, Lambert M, Agard C, André M, Benhamou Y, Bonnotte B, de Boysson H, Espitia O, Fau G, Fauchais A-L, Galateau-Sallé F, Haroche J, Héron E, Lapébie F-X, Liozon E, Luong Nguyen L B, Magnant J, Manrique A, Matt M, de Menthon M, Mouthon L, Puéchal X, Pugnet G, Quemeneur T, Régent A, Saadoun D, Samson M, Sène D, Smets P, Yelnik C, Sailler L, Mahr A
机构信息
Service de médecine interne, CHU de Caen, Normandie university, 14003 Caen, France.
Service de médecine interne, hôpital Dupuytren, CHU de Limoges, université de Limoges, 87000 Limoges, France.
出版信息
Rev Med Interne. 2016 Mar;37(3):154-65. doi: 10.1016/j.revmed.2015.12.015. Epub 2016 Jan 29.
PURPOSE
Management of giant cell arteritis (GCA, Horton's disease) involves many uncertainties. This work was undertaken to establish French recommendations for GCA management.
METHODS
Recommendations were developed by a multidisciplinary panel of 33 physicians, members of the French Study Group for Large Vessel Vasculitis (Groupe d'étude français des artérites des gros vaisseaux [GEFA]). The topics to be addressed, selected from proposals by group members, were assigned to subgroups to summarize the available literature and draft recommendations. Following an iterative consensus-seeking process that yielded consensus recommendations, the degree of agreement among panel members was evaluated with a 5-point Likert scale. A recommendation was approved when ≥ 80% of the voters agreed or strongly agreed.
RESULTS
The 15 retained topics resulted in 31 consensus recommendations focusing on GCA nomenclature and classification, the role of temporal artery biopsy and medical imaging in the diagnosis, indications and search modalities for involvement of the aorta and its branches, the glucocorticoid regimen to prescribe, treatment of complicated GCA, indications for use of immunosuppressants or targeted biologic therapies, adjunctive treatment measures, and management of relapse and recurrence.
CONCLUSIONS
The recommendations, which will be updated regularly, are intended to guide and harmonize the standards of GCA management.
目的
巨细胞动脉炎（GCA，霍顿病）的管理存在诸多不确定性。开展这项工作旨在制定法国关于GCA管理的建议。
方法
建议由33名医生组成的多学科小组制定，这些医生是法国大血管血管炎研究组（Groupe d'étude français des artérites des gros vaisseaux [GEFA]）的成员。从小组成员的提议中选取要讨论的主题，并分配给各个子组，以总结现有文献并起草建议。经过反复寻求共识的过程得出共识性建议后，用5级李克特量表评估小组成员之间的一致程度。当≥80%的投票者同意或强烈同意时，一项建议即获批准。
结果
保留的15个主题产生了31项共识性建议，重点关注GCA的命名和分类、颞动脉活检和医学成像在诊断中的作用、主动脉及其分支受累的指征和检查方式、糖皮质激素治疗方案、复杂性GCA的治疗、免疫抑制剂或靶向生物疗法的使用指征、辅助治疗措施以及复发和再发的管理。
结论
这些建议将定期更新，旨在指导和统一GCA的管理标准。
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