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Review
. 2022 Dec;4(12):e864-e872.
doi: 10.1016/S2665-9913(22)00260-0. Epub 2022 Oct 22.

Pan American League of Associations for Rheumatology guidelines for the treatment of giant cell arteritis

Marina Scolnik  1 , Maria L Brance  2 , Daniel G Fernández-Ávila  3 , Emilia Inoue Sato  4 , Alexandre W S de Souza  4 , Sebastián J Magri  5 , Lina M Saldarriaga-Rivera  6 , Manuel F Ugarte-Gil  7 , Luis F Flores-Suarez  8 , Alejandra Babini  9 , Natalia V Zamora  10 , María L Acosta Felquer  11 , Facundo Vergara  12 , Leandro Carlevaris  13 , Santiago Scarafia  14 , Enrique R Soriano Guppy  11 , Sebastian Unizony  15 ; Pan American League of Associations for Rheumatology (PANLAR)
Affiliations
Review

Pan American League of Associations for Rheumatology guidelines for the treatment of giant cell arteritis

Marina Scolnik et al. Lancet Rheumatol. 2022 Dec.

Abstract

Considerable variability exists in the way that health-care providers treat patients with giant cell arteritis in Latin America, with patients commonly exposed to excessive amounts of glucocorticoids. In addition, large health disparities prevail in this region due to socioeconomic factors, which influence access to care, including biological treatments. For these reasons, the Pan American League of Associations for Rheumatology developed the first evidence-based giant cell arteritis treatment guidelines tailored for Latin America. A panel of vasculitis experts from Mexico, Colombia, Peru, Brazil, and Argentina generated clinically meaningful questions related to the treatment of giant cell arteritis in the population, intervention, comparator, and outcome (PICO) format. Following the grading of recommendations, assessment, development, and evaluation methodology, a team of methodologists did a systematic literature search, extracted and summarised the effects of the interventions, and graded the quality of the evidence. The panel of vasculitis experts voted on each PICO question and made recommendations, which required at least 70% agreement among the voting members to be included in the guidelines. Nine recommendations and one expert opinion statement for the treatment of giant cell arteritis were developed considering the most up-to-date evidence and the socioeconomic characteristics of Latin America. These recommendations include guidance for the use of glucocorticoids, tocilizumab, methotrexate, and aspirin for patients with giant cell arteritis.

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Conflict of interest statement

Declaration of interests Several authors of these guidelines, including voting members, have interacted with the pharmaceutical industry including the manufacturers of some of the drugs mentioned in these recommendations. However, none of the authors received any support or fee directly or indirectly related to or influencing the development of these guidelines. DGF-A, MLB, and ERSG are part of PANLAR committees and were involved in the critical review and editing of the manuscript. No other PANLAR committee member was involved in the writing of the manuscript. NVZ, MLAF, FV, LC, and SS received financial support from PANLAR. MS, AB, SJM, EIS, AWSdS, LMS-R, MFU-G, LFF-S, and SU did not receive financial support for this project from any entity. In addition, MS reports speaker fees from Bristol Myers Squibb, GlaxoSmithKline, Janssen, Elli Lilly, Pfizer, and Roche, and travel grants from Janssen, Pfizer, Roche, and AbbVie, all outside the submitted work. DGF-A reports consulting fees from AbbVie, speaker fees from Amgen, Janssen, Novartis, Elli Lilly, and Pfizer; travel grants from Janssen; and research grants from Pfizer, all outside the submitted work. AB reports speaker fees AbbVie, GlaxoSmithKline, Janssen, Pfizer, Boehringer Ingelheim, Bristol Myers Squibb, all outside the submitted work. SJM reports speaker fees from Roche, Janssen, and GlaxoSmithKline, and travel grants from Roche, Pfizer, AbbVie, Janssen, and Sandoz, all outside the submitted work. EIS reports consulting fees from Janssen outside the submitted work. LMS-R reports consulting fees from Roche, Novartis, and Janssen, and travel grants from Janssen and Novartis, all outside the submitted work. MFU-G reports travel grants from Pfizer and AbbVie, and research grants from Janssen, all outside the submitted work. ERSG reports consulting fees from AbbVie, Amgen, Janssen, Elli Lilly, Novartis, Pfizer, and Sandoz; speaker fees from AbbVie, Amgen, Janssen, Elli Lilly, Novartis, Pfizer, and Sandoz; travel grants from AbbVie; and research grants from Amgen, Novartis, Janssen, and Pfizer, all outside the submitted work. SU reports consulting fees from Kiniksa, Sanofi, GlaxoSmithKline, and Janssen, and research grants from Genentech and Janssen, all outside the submitted work. All other authors declare no competing interests.

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