Yates Max, Watts Richard, Bajema Ingeborg, Cid Maria, Crestani Bruno, Hauser Thomas, Hellmich Bernhard, Holle Julia, Laudien Martin, Little Mark A, Luqmani Raashid Ahmed, Mahr Alfred, Merkel Peter, Mills John, Mooney Janice, Segelmark Mårten, Tesar Vladimir, Westman Kerstin W A, Vaglio Augusto, Yalçındağ Nilüfer, Jayne David R, Mukhtyar Chetan
Department of Rheumatology, Norfolk and Norwich University Hospital, Norwich, UK.
Norwich Medical School, Bob Champion Research and Education Building, Colney Lane, Norwich, UK.
RMD Open. 2017 Jun 15;3(1):e000449. doi: 10.1136/rmdopen-2017-000449. eCollection 2017.
The European League Against Rheumatism recommendations for the management of antineutrophil cytoplasmic antibody-associated vasculitis have been recently published. Unique to recommendation development, they were also voted on by members of a learned society. This paper explores the wider validity of the recommendations among people who self-identify as clinicians caring for patients with vasculitis. In addition to the task force, a learned society (European Vasculitis Society-EUVAS) was invited, through online survey, to rate independently the strength of evidence of each recommendation to obtain an indication of the agreement among the final target audience and ultimate end-users of the recommendations. The survey took place in June 2015. Of the 158 EUVAS members surveyed, there were 88 responses (55.7%). There was a large degree of agreement in the voting patterns between EUVAS survey participants and task force members. Notable exceptions were lower grades for the recommendation of the use of rituximab for remission induction in patients with eosinophilic granulomatosis with polyangiitis and for methotrexate and mycophenolate mofetil as remission maintenance agents in patients with granulomatosis with polyangiitis/microscopic polyangiitis by EUVAS members. These results are encouraging and suggest that the voting patterns of the task force are representative of the wider vasculitis community. We recommend future recommendations adopt this approach for data/expert-based treatment guidelines, especially for multisystem diseases.
欧洲抗风湿病联盟关于抗中性粒细胞胞浆抗体相关血管炎管理的建议最近已发布。与建议制定的独特之处在于，它们还经过了一个学术团体成员的投票。本文探讨了这些建议在自我认定为照顾血管炎患者的临床医生中的更广泛有效性。除了特别工作组外，还通过在线调查邀请了一个学术团体（欧洲血管炎协会-EUVAS）独立评估每项建议的证据强度，以了解最终目标受众和建议的最终用户之间的一致程度。调查于2015年6月进行。在接受调查的158名EUVAS成员中，有88人回复（55.7%）。EUVAS调查参与者和特别工作组成员之间的投票模式有很大程度的一致性。值得注意的例外是，EUVAS成员对在嗜酸性肉芽肿性多血管炎患者中使用利妥昔单抗诱导缓解以及在肉芽肿性多血管炎/显微镜下多血管炎患者中使用甲氨蝶呤和霉酚酸酯作为缓解维持药物的建议评分较低。这些结果令人鼓舞，并表明特别工作组的投票模式代表了更广泛的血管炎群体。我们建议未来的建议采用这种基于数据/专家的治疗指南方法，特别是对于多系统疾病。
