Evidence map›Paper›PMID 37349121›Full record

SynthesisRMD open2023

Systematic literature review informing the 2022 update of the EULAR recommendations for the management of ANCA-associated vasculitis (AAV): Part 2 - Treatment of eosinophilic granulomatosis with polyangiitis and diagnosis and general management of AAV.

Beatriz Sanchez-Alamo, Jan Henrik Schirmer, Bernhard Hellmich, David Jayne, Sara Monti, Gunnar Tomasson, Raashid Ahmed Luqmani

Open access · goldAbstract readSystematic Review
In one paragraph

Synthesis in RMD open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 2 pooled it
4.4field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 17 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 5 countries.

Beatriz Sanchez-Alamo *Nephrology, Hospital Universitario del Sureste, Arganda del Rey, Madrid, Spain.ORCID 0000-0002-7835-543X
Jan Henrik Schirmer *Clinic for Internal Medicine I, Rheumatology and Clinical Immunology, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany janhenrik.schirmer@uksh.de.ORCID 0000-0001-5467-2783
Bernhard HellmichDepartment of Internal Medicine, Rheumatology and Immunology, Medius Kliniken Kirchheim/Teck, University Tübingen, Kirchheim-Teck, Germany.ORCID 0000-0002-8014-1801
David JayneDepartment of Medicine, University of Cambridge, Cambridge, UK.ORCID 0000-0002-1712-0637
Sara MontiDepartment of Internal Medicine and Therapeutics, University of Pavia; Division of Rheumatology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.ORCID 0000-0002-1800-6772
Gunnar TomassonFaculty of Medicine, University of Iceland, Landspitali University Hospital, Reykjavik, Iceland.ORCID 0000-0002-1797-7091
Raashid Ahmed LuqmaniOxford NIHR Biomedical Research Centre, Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
Hospital Universitario del Sureste · ESUniversity of Cambridge · GBUniversity of Iceland · ISUniversity of Oxford · GBUniversity of Pavia · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo summarise and update evidence to inform the 2022 update of the European Alliance of Associations of Rheumatology (EULAR) recommendations for the management of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV).

methodsThree systematic literature reviews (SLR) were performed. PubMed, EMBASE and the Cochrane library were searched from 1 February 2015 to 25 February 2022. The evidence presented herein covers the treatment of eosinophilic granulomatosis with polyangiitis (EGPA) as well as diagnostic testing and general management of all AAV syndromes.

resultsFor the treatment of EGPA, diagnostic procedures and general management 3517, 4137 and 4215 articles were screened and 26, 110 and 63 articles were included in the final evidence syntheses, respectively. For EGPA patients with newly diagnosed disease without unfavourable prognostic factors, azathioprine (AZA) combined with glucocorticoids (GC) is not superior to GC monotherapy to induce remission (LoE 2b). In patients with active EGPA and unfavourable prognostic factors, cyclophosphamide or rituximab can be used for remission induction (LoE 2b). Treatment with Mepolizumab added to standard treatment results in higher rates of sustained remission in patients with relapsing or refractory EGPA without active organ-threatening or life-threatening manifestations (LoE 1b) and reduces GC use. Kidney biopsies have prognostic value in AAV patients with renal involvement (LoE 2a). In the context of suspected AAV, immunoassays for proteinase 3 and myeloperoxidase-ANCA have higher diagnostic accuracy compared with indirect immunofluorescent testing (LoE 1a).

conclusionThis SLR provides current evidence to inform the 2022 update of the EULAR recommendations for the management of AAV.

Indexed as

Anti-Neutrophil Cytoplasmic Antibody-Associated VasculitisChurg-Strauss SyndromeGranulomatosis with PolyangiitisRheumatologyAntibodies, Antineutrophil CytoplasmicHumansAntibodies, Antineutrophil CytoplasmicCyclophosphamideGranulomatosis with polyangiitisRituximabSystemic vasculitis

Identifiers

PMID37349121
PMCPMC10314689
OpenAlexW4381716650

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.