TY - JOUR
T1 - A Dutch consensus statement on the diagnosis and treatment of ANC A-associated vasculitis
AU - Dirikgil, E.
AU - Tas, S. W.
AU - Rutgers, A.
AU - Verhoeven, P. M. J.
AU - van Laar, J. M.
AU - Hagen, E. C.
AU - Tekstra, J.
AU - Hak, A. E. L.
AU - van Paassen, P.
AU - Kok, M. R.
AU - Goldschmeding, R.
AU - van Dam, B.
AU - Douma, C. E.
AU - Remmelts, H. H. F.
AU - Sanders, J. F.
AU - Jonker, J. T.
AU - Rabelink, T. J.
AU - Damoiseaux, J. G. M. C.
AU - Moens, H. J. Bernelot
AU - Bos, W. J. W.
AU - Teng, Y. K. O.
AU - Arthritis Research & Collaboration Hub consortium
PY - 2020/3
Y1 - 2020/3
N2 - Introduction: Despite the availability of several guidelines on the diagnosis and treatment of antineutrophil cytoplasmic antibody-associated vasculitis (AAV), clinical routine practice will only improve when an implementation strategy is in place to support clinical decision making and adequate implementation of guidelines. We describe here an initiative to establish national and multidisciplinary consensus on broad aspects of the diagnosis and treatment of AAV relevant to daily clinical practice in the Netherlands.Methods: A multidisciplinary working group of physicians in the Netherlands with expertise on AAV addressed the broad spectrum of diagnosis, terminology, and immunosuppressive and non-immunosuppressive treatment, including an algorithm for AAV patients. Based on recommendations from (inter)national guidelines, national consensus was established using a Delphi-based method during a conference in conjunction with a nationally distributed online consensus survey. Cut-off for consensus was 70% (dis)agreement.Results: Ninety-eight professionals were involved in the Delphi procedure to assess consensus on 5o statements regarding diagnosis, treatment, and organisation of care for AAV patients. Consensus was achieved for 37/50 statements (74%) in different domains of diagnosis and treatment of AAV including consensus on the treatment algorithm for AAV.Conclusion: We present a national, multidisciplinary consensus on a diagnostic strategy and treatment algorithm for AAV patients as part of the implementation of (inter)national guideline-derived recommendations in the Netherlands. Future studies will focus on evaluating local implementation of treatment protocols for AAV, and assessments of current and future clinical practice variation in the care for AAV patients in the Netherlands.
AB - Introduction: Despite the availability of several guidelines on the diagnosis and treatment of antineutrophil cytoplasmic antibody-associated vasculitis (AAV), clinical routine practice will only improve when an implementation strategy is in place to support clinical decision making and adequate implementation of guidelines. We describe here an initiative to establish national and multidisciplinary consensus on broad aspects of the diagnosis and treatment of AAV relevant to daily clinical practice in the Netherlands.Methods: A multidisciplinary working group of physicians in the Netherlands with expertise on AAV addressed the broad spectrum of diagnosis, terminology, and immunosuppressive and non-immunosuppressive treatment, including an algorithm for AAV patients. Based on recommendations from (inter)national guidelines, national consensus was established using a Delphi-based method during a conference in conjunction with a nationally distributed online consensus survey. Cut-off for consensus was 70% (dis)agreement.Results: Ninety-eight professionals were involved in the Delphi procedure to assess consensus on 5o statements regarding diagnosis, treatment, and organisation of care for AAV patients. Consensus was achieved for 37/50 statements (74%) in different domains of diagnosis and treatment of AAV including consensus on the treatment algorithm for AAV.Conclusion: We present a national, multidisciplinary consensus on a diagnostic strategy and treatment algorithm for AAV patients as part of the implementation of (inter)national guideline-derived recommendations in the Netherlands. Future studies will focus on evaluating local implementation of treatment protocols for AAV, and assessments of current and future clinical practice variation in the care for AAV patients in the Netherlands.
KW - ANCA-associated vasculitis
KW - pauci-immune glomerulonephritis
KW - recommendations
KW - PNEUMOCYSTIS-CARINII-PNEUMONIA
KW - ANTIBODY-ASSOCIATED VASCULITIS
KW - ANTINEUTROPHIL CYTOPLASM ANTIBODY
KW - AZATHIOPRINE MAINTENANCE THERAPY
KW - DAILY ORAL CYCLOPHOSPHAMIDE
KW - NATIVE KIDNEY BIOPSY
KW - RANDOMIZED-TRIAL
KW - MICROSCOPIC POLYANGIITIS
KW - INTERNATIONAL CONSENSUS
KW - WEGENERS-GRANULOMATOSIS
M3 - Article
VL - 78
SP - 71
EP - 82
JO - Netherlands Journal of Medicine
JF - Netherlands Journal of Medicine
SN - 0300-2977
IS - 2
ER -