THE OFFICIAL NEWS SOURCE OF ACR CONVERGENCE 2022 • NOVEMBER 10-14



ACR/Vasculitis Foundation developing new guideline for managing GPA, MPA, and EGPA

Sharon Chung, MD
Sharon Chung, MD

The first-ever ACR guideline being developed for the management of granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (EGPA) provides useful recommendations for managing these complex conditions in clinical practice. The Sunday session, ANCA-Associated Vasculitis: How to Apply the New ACR Guidelines, from 8:30 – 10:00 am in the Thomas Murphy Ballroom 3 & 4, Building B in the Georgia World Congress Center, will discuss the draft of this new guideline.

Sharon Chung, MD, principal investigator and head of the core oversight team that developed the guideline, will review the new drafted guideline for GPA and MPA and discuss its clinical applications. Dr. Chung is Associate Professor of Medicine in the Division of Rheumatology and Director of the Vasculitis Clinic at the University of California, San Francisco. Joining Dr. Chung will be core oversight team member Carol Langford, MD, MHS, who will review the guideline recommendations for EGPA. Dr. Langford is Director of the Center for Vasculitis Care and Research at the Cleveland Clinic.

“The systemic vasculitides are a group of diseases that are rare, even for general rheumatologists, and can have organ-threatening and life-threatening manifestations,” Dr. Chung said. “Given their many manifestations, potential mimickers, and now increasing treatment options, the diagnosis, treatment, and management of these diseases can be challenging.”

Rheumatologists who do not treat the diseases regularly, she said, often seek the guidance of colleagues and experts to develop treatment and management plans for their patients. The new guidelines address seven classic systemic vasculitides — giant cell arteritis (GCA), Takayasu arteritis (TAK), polyarteritis nodosa (PAN), Kawasaki disease, as well as the three ANCA associated vasculitides.

“For the ANCA-associated vasculitides, we will be providing recommendations regarding the use of remission induction and maintenance therapy, management of severe and non-severe disease, and laboratory studies to monitor disease and guide treatments,” Dr. Chung said. “For large vessel vasculitis, the guidelines provide recommendations regarding the use of imaging to diagnose and monitor patients, the use of glucocorticoid sparing therapies, and surgical interventions for management.”

Two sessions on Monday will cover the new guideline recommendations for GCA, TAK, PAN and Kawasaki disease. GCA, TAK & PAN: How to Apply the New ACR Guidelines (see story in Tuesday’s ACR Daily News) will take place from 8:30 – 10:00 am in Hall B1, and  Kawasaki Disease Treatment: Old & New in 2019 (see story on page A15) will be held from 11:00 am – 12:00 pm in Room B216-B217.

During Monday’s sessions, Dr. Chung said, faculty will present treatment and management recommendations for clinical scenarios when rheumatologists are consulted for Kawasaki disease as well as recommendations regarding treatment of polyarteritis nodosa, including the use of imaging and biopsy studies for diagnosis.

“This is the ACR’s first effort to develop guidelines for the management of these complex diseases,” Dr. Chung said. “At the end of these sessions, we hope attendees will not only have a clear view of the basic tenets regarding the treatment of these diseases, but also recognize that there are nuances relevant to each patient that will influence each patient’s treatment plan.”

The new guidelines, developed in partnership with the Vasculitis Foundation, are expected to be finalized, approved, and published in spring 2020.