European consensus-based recommendations for the diagnosis and treatment of rare paediatric vasculitides – the SHARE initiative

Author:

de Graeff Nienke1,Groot Noortje123ORCID,Brogan Paul4,Ozen Seza5,Avcin Tadej6,Bader-Meunier Brigitte7,Dolezalova Pavla8,Feldman Brian M9,Kone-Paut Isabelle10,Lahdenne Pekka11,Marks Stephen D4,McCann Liza3,Pilkington Clarissa4,Ravelli Angelo12,van Royen Annet1,Uziel Yosef13,Vastert Bas1,Wulffraat Nico1,Kamphuis Sylvia2,Beresford Michael W314ORCID

Affiliation:

1. Department of Paediatric Rheumatology, Wilhelmina Children’s Hospital, Utrecht

2. Department of Paediatric Rheumatology, Sophia Children's Hospital, Erasmus Medical Centre, Rotterdam, The Netherlands

3. Department of Paediatric Rheumatology, Alder Hey Children's Hospital, Liverpool

4. Department of Paediatric Rheumatology, University College London Great Ormond Street Institute of Child Health and Great Ormond St Hospital for Children NHS Foundation Trust, London, UK

5. Department of Paediatric Rheumatology, Hacettepe University, Ankara, Turkey

6. Department of Paediatric Rheumatology, University Children's Hospital Ljubljana, Ljubljana, Slovenia

7. Department of Paediatric Rheumatology, Necker Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France

8. 1st Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic

9. Department of Paediatric Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Canada

10. Department of Paediatric Rheumatology, Bicêtre University Hospital, APHP, University of Paris Sud, Paris, France

11. Department of Paediatric Rheumatology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland

12. Department of Paediatric Rheumatology, Gaslini Children's Hospital, Genoa, Italy

13. Meir Medical Center, Kfar Saba, Tel Aviv University, Sackler School of Medicine, Tel Aviv, Israel

14. Institute of Translational Medicine, University of Liverpool, Liverpool, UK

Abstract

Abstract Objectives The European initiative Single Hub and Access point for paediatric Rheumatology in Europe (SHARE) aimed to optimize care for children with rheumatic diseases. Systemic vasculitides are very rare in children. Consequently, despite recent advances, paediatric-specific information is sparse. The lack of evidence-based recommendations is an important, unmet need. This study aimed to provide recommendations for diagnosing and treating children with rare forms of childhood systemic vasculitis. Methods Recommendations were developed by a consensus process in accordance with the European League Against Rheumatism standard operating procedures. A systematic literature review informed the recommendations, which were devised and evaluated by a panel of experts via an online survey, and two consensus meetings using nominal group technique. Recommendations were accepted when ⩾ 80% of experts agreed. Results Ninety-three relevant articles were found, and 78 recommendations were accepted in the two consensus meetings. General, cross-cutting recommendations and disease-specific statements regarding the diagnosis and treatment of childhood-onset PAN, granulomatosis with polyangiitis, microscopic polyangiitis, eosinophilic granulomatosis with polyangiitis, and Takayasu arteritis are provided. Conclusion These Single Hub and Access point for paediatric Rheumatology in Europe recommendations were formulated through an evidence-based consensus process to support uniform, high-quality standard of care for children with rare forms of paediatric systemic vasculitis.

Funder

European Agency for Health and Consumers

EAHC

Publisher

Oxford University Press (OUP)

Subject

Pharmacology (medical),Rheumatology

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