CanVasc Consensus Recommendations for the Management of Antineutrophil Cytoplasm Antibody-associated Vasculitis: 2020 Update

Arielle Mendel; Daniel Ennis; Ellen Go; Volodko Bakowsky; Corisande Baldwin; Susanne M Benseler; David A Cabral; Simon Carette; Marie Clements-Baker; Alison H Clifford; Jan Willem Cohen Tervaert; Gerard Cox; Natasha Dehghan; Christine Dipchand; Navjot Dhindsa; Leilani Famorca; Aurore Fifi-Mah; Stephanie Garner; Louis-Philippe Girard; Clode Lessard; Patrick Liang; Damien Noone; Jean-Paul Makhzoum; Nataliya Milman; Christian A Pineau; Heather N Reich; Maxime Rhéaume; David B Robinson; Dax G Rumsey; Tanveer E Towheed; Judith Trudeau; Marinka Twilt; Elaine Yacyshyn; Rae S M Yeung; Lillian B Barra; Nader Khalidi; Christian Pagnoux

doi:10.3899/jrheum.200721

CanVasc Consensus Recommendations for the Management of Antineutrophil Cytoplasm Antibody-associated Vasculitis: 2020 Update

J Rheumatol. 2021 Apr;48(4):555-566. doi: 10.3899/jrheum.200721. Epub 2020 Sep 15.

Authors

Arielle Mendel¹, Daniel Ennis², Ellen Go³, Volodko Bakowsky⁴, Corisande Baldwin², Susanne M Benseler⁵, David A Cabral⁶, Simon Carette⁷, Marie Clements-Baker⁸, Alison H Clifford⁹, Jan Willem Cohen Tervaert⁹, Gerard Cox¹⁰, Natasha Dehghan², Christine Dipchand¹¹, Navjot Dhindsa², Leilani Famorca¹², Aurore Fifi-Mah¹³, Stephanie Garner¹², Louis-Philippe Girard¹⁴, Clode Lessard¹⁵, Patrick Liang¹⁶, Damien Noone¹⁷, Jean-Paul Makhzoum¹⁸, Nataliya Milman¹⁹, Christian A Pineau²⁰, Heather N Reich²¹, Maxime Rhéaume¹⁸, David B Robinson²², Dax G Rumsey²³, Tanveer E Towheed⁸, Judith Trudeau²⁴, Marinka Twilt⁵, Elaine Yacyshyn⁹, Rae S M Yeung³, Lillian B Barra²⁵, Nader Khalidi¹², Christian Pagnoux⁷

Affiliations

¹ A. Mendel, MD, MSc, C.A. Pineau, MD, Division of Rheumatology, Lupus and Vasculitis Clinic, McGill University, Montréal, Québec; [email protected].
² D. Ennis, MD, C. Baldwin, MD, N. Dehghan, MD, N. Dhindsa, MD, Division of Rheumatology, University of British Columbia, Vancouver, British Columbia.
³ E. Go, MD, R.S. Yeung, MD, PhD, Division of Rheumatology, Hospital for Sick Children, University of Toronto, Toronto, Ontario.
⁴ V. Bakowsky, MD, Division of Rheumatology, QEII Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia.
⁵ S.M. Benseler, MD, PhD, M. Twilt, MD, PhD, Division of Rheumatology, Department of Pediatrics, Alberta Children's Hospital, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta.
⁶ D.A. Cabral, MBBS, Division of Pediatric Rheumatology, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia.
⁷ S. Carette, MD, MPhil, C. Pagnoux, MD, MSc, MPH, Division of Rheumatology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario.
⁸ M. Clements-Baker, MD, T.E. Towheed, MD, MS, Division of Rheumatology, Queen's University, Kingston, Ontario.
⁹ A.H. Clifford, MD, J.W. Cohen Tervaert, MD, PhD, E. Yacyshyn, MD, Division of Rheumatology, University of Alberta, Edmonton, Alberta.
¹⁰ G. Cox, MB, Firestone Institute for Respiratory Health, McMaster University, Hamilton, Ontario.
¹¹ C. Dipchand, MD, MSc, Division of Nephrology, QEII Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia.
¹² L. Famorca, MD, S. Garner, MD, MSc, N. Khalidi, MD, Division of Rheumatology, McMaster University, Hamilton, Ontario.
¹³ A. Fifi-Mah, MD, Division of Rheumatology, University of Calgary, Calgary, Alberta.
¹⁴ L.P. Girard, MD, MSc, Division of Nephrology, University of Calgary, Calgary, Alberta.
¹⁵ C. Lessard, MD, Centre de Recherche Musculo-Squelettique, Trois-Rivières, Québec.
¹⁶ P. Liang, MD, Division of Rheumatology, Centre Hospitalier Universitaire de Sherbrooke, Université de Sherbrooke, Sherbrooke, Québec.
¹⁷ D. Noone, MB, BCh, BAO, MSc, Division of Nephrology, Hospital for Sick Children, University of Toronto, Toronto, Ontario.
¹⁸ J.P. Makhzoum, MD, M. Rhéaume, MD, Division of Internal Medicine, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montréal, Québec.
¹⁹ N. Milman, MD, MSc, Division of Rheumatology, The Ottawa Hospital, University of Ottawa and Ottawa Hospital Research Institute, Ottawa, Ontario.
²⁰ A. Mendel, MD, MSc, C.A. Pineau, MD, Division of Rheumatology, Lupus and Vasculitis Clinic, McGill University, Montréal, Québec.
²¹ H.N. Reich, MD, PhD, Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario.
²² D.B. Robinson, MD, MSc, Section of Rheumatology, University of Manitoba, Winnipeg, Manitoba.
²³ D.G. Rumsey, MD, MSc, Division of Pediatric Rheumatology, University of Alberta, Edmonton, Alberta.
²⁴ J. Trudeau, MD, Division of Rheumatology, CISSS Chaudière-Appalaches, Université Laval, Québec City, Québec.
²⁵ L.B. Barra, MD, Division of Rheumatology, Department of Medicine, Western University, London, Ontario, Canada.

PMID: 32934123
DOI: 10.3899/jrheum.200721

Abstract

Objective: In 2015, the Canadian Vasculitis Research Network (CanVasc) created recommendations for the management of antineutrophil cytoplasm antibody (ANCA)-associated vasculitides (AAV) in Canada. The current update aims to revise existing recommendations and create additional recommendations, as needed, based on a review of new available evidence.

Methods: A needs assessment survey of CanVasc members informed questions for an updated systematic literature review (publications spanning May 2014 to September 2019) using Medline, Embase, and Cochrane. New and revised recommendations were developed and categorized according to the level of evidence and strength of each recommendation. The CanVasc working group used a 2-step modified Delphi procedure to reach > 80% consensus on the inclusion, wording, and grading of each new and revised recommendation.

Results: Eleven new and 16 revised recommendations were created and 12 original (2015) recommendations were retained. New and revised recommendations are discussed in detail within this document. Five original recommendations were removed, of which 4 were incorporated into the explanatory text. The supplementary material for practical use was revised to reflect the updated recommendations.

Conclusion: The 2020 updated recommendations provide rheumatologists, nephrologists, and other specialists caring for patients with AAV in Canada with new management guidance, based on current evidence and consensus from Canadian experts.

Keywords: antineutrophil cytoplasm antibody-associated vasculitis; eosinophilic granulomatosis with polyangiitis; glomerulonephritis; granulomatosis with polyangiitis; microscopic polyangiitis.

Publication types

Systematic Review

MeSH terms

Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis* / drug therapy
Antibodies, Antineutrophil Cytoplasmic
Canada
Consensus
Cytoplasm
Humans

Substances

Antibodies, Antineutrophil Cytoplasmic