Real-world clinical decisions of physicians in the management of Takayasu arteritis and giant cell arteritis in...

Area of Science:

• Rheumatology
• Internal Medicine
• Clinical Practice Guidelines

Background:

• Takayasu arteritis (TAK) and giant cell arteritis (GCA) are large vessel vasculitides requiring effective management strategies.
• The Japanese Circulation Society (JCS) published guidelines in 2017 to standardize treatment approaches.
• Understanding real-world physician practices post-guideline publication is crucial for evaluating their impact.

Purpose of the Study:

• To assess the current clinical management of Takayasu arteritis (TAK) and giant cell arteritis (GCA) by physicians in Japan.
• To evaluate physician adherence to and utilization of the 2017 JCS Guidelines for Vasculitis Syndrome.
• To identify trends in diagnostic methods and therapeutic interventions for these conditions.

Main Methods:

• A descriptive, cross-sectional study was conducted.
• Self-administered electronic questionnaires were distributed to physicians treating TAK or GCA.
• Data were collected from 329 physicians registered with Macromill Inc. in February 2022.

Main Results:

• The 2017 JCS Guidelines were the most frequently consulted resource (70%) for clinical questions.
• Ophthalmoscopy rates were 50% for TAK and 70% for GCA.
• 18F-FDG-PET/CT utilization was 23% (TAK) and 20% (GCA) at diagnosis, decreasing to 10% at 12-month follow-up.
• Tocilizumab, combined with glucocorticoids, was the preferred medication for remission induction in relapsed TAK and GCA patients.

Conclusions:

• The majority of physicians managing TAK and GCA in Japan reference the 2017 JCS guidelines.
• This study provides a clear picture of current clinical practice for large vessel vasculitis in Japan.
• Findings will aid in the future revision of the JCS guidelines for vasculitis management.