PMID- 30001655 OWN - NLM STAT- MEDLINE DCOM- 20190408 LR - 20220408 IS - 1439-7609 (Electronic) IS - 1439-7595 (Linking) VI - 29 IP - 1 DP - 2019 Jan TI - 2017 Clinical practice guidelines of the Japan Research Committee of the Ministry of Health, Labour, and Welfare for Intractable Vasculitis for the management of ANCA-associated vasculitis. PG - 20-30 LID - 10.1080/14397595.2018.1500437 [doi] AB - OBJECTIVE: The Japan Research Committee for Intractable Vasculitis has fully revised the clinical practice guidelines (CPG) for the management of antineutrophil cytoplasmic antibody-associated vasculitis (AAV) to improve and standardize the medical treatment of the disease in Japan. METHODS: The previous CPG was published in a classical review style in Japanese in 2011 and 2014. We adopted the Grading of Recommendations Assessment, Development and Evaluation system for this revision, and various stakeholders, including patients, participated in it. The expected users of this CPG are AAV patients in Japan and their families and healthcare professionals, including both AAV specialists and non-specialists. We set clinical questions concerning the three important clinical topics of remission induction therapy, plasma exchange, remission maintenance therapy, and developed eight recommendation statements. RESULTS: For remission induction therapy for newly developed AAV, we weakly recommend glucocorticoid (GC) plus intravenous cyclophosphamide pulse (IVCY) or oral cyclophosphamide (POCY) rather than GC alone, and IVCY rather than POCY. We also weakly recommend CY rather than rituximab. In the case of AAV with severe renal impairment, we weakly recommend plasma exchange as a conjunction therapy. We weakly recommend azathioprine for remission maintenance therapy. CONCLUSION: The revised CPG has demonstrated evidence-based treatment recommendations for AAV. FAU - Harigai, Masayoshi AU - Harigai M AD - a Division of Epidemiology and Pharmacoepidemiology, Department of Rheumatology, School of Medicine , Tokyo Women's Medical University , Tokyo , Japan. FAU - Nagasaka, Kenji AU - Nagasaka K AD - b Department of Rheumatology , Ome Municipal General Hospital , Tokyo , Japan. AD - c Department of Pharmacovigilance, Graduate School of Medical and Dental Sciences , Tokyo Medical and Dental University , Tokyo , Japan. FAU - Amano, Koichi AU - Amano K AD - d Department of Rheumatology and Clinical Immunology, Saitama Medical Center , Saitama Medical School , Saitama , Japan. FAU - Bando, Masashi AU - Bando M AD - e Division of Pulmonary Medicine, Department of Medicine , Jichi Medical University , Tochigi , Japan. FAU - Dobashi, Hiroaki AU - Dobashi H AD - f Division of Hematology , Rheumatology and Respiratory Medicine Department of Internal Medicine Faculty of Medicine Kagawa University , Kagawa , Japan. FAU - Kawakami, Tamihiro AU - Kawakami T AD - g Department of Dermatology , St. Marianna University School of Medicine , Kanagawa , Japan. FAU - Kishibe, Kan AU - Kishibe K AD - h Department of Otolaryngology-Head and Neck Surgery , Asahikawa Medical University , Hokkaido , Japan. FAU - Murakawa, Yohko AU - Murakawa Y AD - i Department of Rheumatology , Shimane University Faculty of Medicine , Shimane , Japan. FAU - Usui, Joichi AU - Usui J AD - j Department of Nephrology, Faculty of Medicine , University of Tsukuba , Ibaraki , Japan. FAU - Wada, Takashi AU - Wada T AD - k Department of Nephrology and Laboratory Medicine, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences , Kanazawa University , Ishikawa , Japan. FAU - Tanaka, Eiichi AU - Tanaka E AD - l Department of Rheumatology, School of Medicine , Tokyo Women's Medical University , Tokyo , Japan. FAU - Nango, Eishu AU - Nango E AD - m Department of General Medicine , Tokyo Kita Medical Center , Tokyo , Japan. FAU - Nakayama, Takeo AU - Nakayama T AD - n Department of Health Informatics, Graduate School of Medicine and Public Health , Kyoto University , Kyoto , Japan. FAU - Tsutsumino, Michi AU - Tsutsumino M AD - l Department of Rheumatology, School of Medicine , Tokyo Women's Medical University , Tokyo , Japan. FAU - Yamagata, Kunihiro AU - Yamagata K AD - j Department of Nephrology, Faculty of Medicine , University of Tsukuba , Ibaraki , Japan. FAU - Homma, Sakae AU - Homma S AD - o Department of Respiratory Medicine , Toho University Omori Medical Center , Tokyo , Japan. FAU - Arimua, Yoshihiro AU - Arimua Y AD - p Division of Nephrology and Rheumatology, First Department of Internal Medicine , Kyorin University School of Medicine , Tokyo , Japan. LA - eng PT - Journal Article PT - Practice Guideline DEP - 20180910 PL - England TA - Mod Rheumatol JT - Modern rheumatology JID - 100959226 RN - 0 (Glucocorticoids) RN - 0 (Immunosuppressive Agents) RN - 4F4X42SYQ6 (Rituximab) RN - 8N3DW7272P (Cyclophosphamide) RN - MRK240IY2L (Azathioprine) SB - IM MH - Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/*therapy MH - Azathioprine/*administration & dosage/therapeutic use MH - Cyclophosphamide/*administration & dosage MH - Drug Administration Routes MH - Drug Administration Schedule MH - Drug Therapy, Combination/methods MH - Glucocorticoids/*administration & dosage MH - Humans MH - Immunosuppressive Agents/administration & dosage MH - Japan MH - Maintenance Chemotherapy/methods MH - Plasma Exchange/*methods MH - Plasmapheresis/*methods MH - Remission Induction/methods MH - Rituximab/*administration & dosage OTO - NOTNLM OT - ANCA-associated vasculitis OT - GRADE system OT - clinical practice guideline OT - granulomatosis with polyangiitis OT - microscopic polyangiitis EDAT- 2018/07/14 06:00 MHDA- 2019/04/09 06:00 CRDT- 2018/07/14 06:00 PHST- 2018/07/14 06:00 [pubmed] PHST- 2019/04/09 06:00 [medline] PHST- 2018/07/14 06:00 [entrez] AID - 10.1080/14397595.2018.1500437 [doi] PST - ppublish SO - Mod Rheumatol. 2019 Jan;29(1):20-30. doi: 10.1080/14397595.2018.1500437. Epub 2018 Sep 10.