B Bienvenu1, K H Ly2, M Lambert3, C Agard4, M André5, Y Benhamou6, B Bonnotte7, H de Boysson1, O Espitia4, G Fau8, A-L Fauchais2, F Galateau-Sallé9, J Haroche10, E Héron11, F-X Lapébie2, E Liozon2, L B Luong Nguyen12, J Magnant13, A Manrique14, M Matt2, M de Menthon8, L Mouthon15, X Puéchal15, G Pugnet16, T Quemeneur17, A Régent15, D Saadoun18, M Samson7, D Sène19, P Smets5, C Yelnik3, L Sailler16, A Mahr20. 1. Service de médecine interne, CHU de Caen, Normandie university, 14003 Caen, France. 2. Service de médecine interne, hôpital Dupuytren, CHU de Limoges, université de Limoges, 87000 Limoges, France. 3. Service de médecine interne, hôpital Huriez, CHRU de Lille, université Nord-de-France, 59037 Lille, France. 4. Service de médecine interne, hôpital Hôtel-Dieu, CHU de Nantes, université de Nantes, 44093 Nantes, France. 5. Service de médecine interne, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, université d'Auvergne, 63001 Clermont-Ferrand, France. 6. Département de médecine interne, CHU de Rouen, université de Rouen, 76031 Rouen, France. 7. Service de médecine interne et immunologie clinique, CHU François-Mitterrand, université de Bourgogne Franche-Comté, 21079 Dijon, France. 8. Service de radiologie centrale, hôpital Hôtel-Dieu, CHU de Nantes, université de Nantes, 44093 Nantes, France. 9. Département d'anatomie pathologique, CHU de Caen, université de Normandie, 14003 Caen, France. 10. Service de médecine interne 2, CHU Pitié-Salpêtrière, université Paris 6, 75013 Paris, France. 11. Service de médecine interne, centre hospitalier national d'ophtalmologie des Quinze-Vingts, université Paris 6, 75012 Paris, France. 12. Unité de médecine interne-maladies systémiques, département de médecine interne, hôpital Saint-Louis, CHU Saint-Louis, université Paris Diderot, 1, avenue Claude-Vellefaux, 75010 Paris, France. 13. Service de médecine interne, CHU de Tours, université François-Rabelais, 37044 Tours, France. 14. Service de médecine nucléaire, CHU de Caen, Normandie université, 14003 Caen, France. 15. Service de médecine interne, CHU de Cochin, université Paris 5-René Descartes, 75014 Paris, France. 16. Service de médecine interne, hôpital Purpan, CHU de Toulouse, université de Toulouse, 31059 Toulouse, France. 17. Service de médecine interne et néphrologie, hôpital de Valenciennes, 59300 Valenciennes, France. 18. Département de médecine interne et immunologie clinique, CHU Pitié-Salpêtrière, université Paris 6, 75013 Paris, France. 19. Département de médecine interne, CHU Lariboisière, université Paris Diderot, 75010 Paris, France. 20. Unité de médecine interne-maladies systémiques, département de médecine interne, hôpital Saint-Louis, CHU Saint-Louis, université Paris Diderot, 1, avenue Claude-Vellefaux, 75010 Paris, France. Electronic address: alfred.mahr@aphp.fr.
Abstract
PURPOSE: Management of giant cell arteritis (GCA, Horton's disease) involves many uncertainties. This work was undertaken to establish French recommendations for GCA management. METHODS: Recommendations were developed by a multidisciplinary panel of 33 physicians, members of the French Study Group for Large Vessel Vasculitis (Groupe d'étude français des artérites des gros vaisseaux [GEFA]). The topics to be addressed, selected from proposals by group members, were assigned to subgroups to summarize the available literature and draft recommendations. Following an iterative consensus-seeking process that yielded consensus recommendations, the degree of agreement among panel members was evaluated with a 5-point Likert scale. A recommendation was approved when ≥ 80% of the voters agreed or strongly agreed. RESULTS: The 15 retained topics resulted in 31 consensus recommendations focusing on GCA nomenclature and classification, the role of temporal artery biopsy and medical imaging in the diagnosis, indications and search modalities for involvement of the aorta and its branches, the glucocorticoid regimen to prescribe, treatment of complicated GCA, indications for use of immunosuppressants or targeted biologic therapies, adjunctive treatment measures, and management of relapse and recurrence. CONCLUSIONS: The recommendations, which will be updated regularly, are intended to guide and harmonize the standards of GCA management.
PURPOSE: Management of giant cell arteritis (GCA, Horton's disease) involves many uncertainties. This work was undertaken to establish French recommendations for GCA management. METHODS: Recommendations were developed by a multidisciplinary panel of 33 physicians, members of the French Study Group for Large Vessel Vasculitis (Groupe d'étude français des artérites des gros vaisseaux [GEFA]). The topics to be addressed, selected from proposals by group members, were assigned to subgroups to summarize the available literature and draft recommendations. Following an iterative consensus-seeking process that yielded consensus recommendations, the degree of agreement among panel members was evaluated with a 5-point Likert scale. A recommendation was approved when ≥ 80% of the voters agreed or strongly agreed. RESULTS: The 15 retained topics resulted in 31 consensus recommendations focusing on GCA nomenclature and classification, the role of temporal artery biopsy and medical imaging in the diagnosis, indications and search modalities for involvement of the aorta and its branches, the glucocorticoid regimen to prescribe, treatment of complicated GCA, indications for use of immunosuppressants or targeted biologic therapies, adjunctive treatment measures, and management of relapse and recurrence. CONCLUSIONS: The recommendations, which will be updated regularly, are intended to guide and harmonize the standards of GCA management.
Authors: Hubert de Boysson; Anael Dumont; Eric Liozon; Marc Lambert; Jonathan Boutemy; Gwénola Maigné; Nicolas Martin Silva; Audrey Sultan; Kim Heang Ly; Nicolas Aide; Alain Manrique; Boris Bienvenu; Achille Aouba Journal: Eur J Nucl Med Mol Imaging Date: 2017-07-24 Impact factor: 9.236