The 2025 British Society for Rheumatology management recommendations for ANCA-associated vasculitis

Area of Science:

• Rheumatology
• Immunology
• Clinical Medicine

Background:

• ANCA-associated vasculitis (AAV) encompasses granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (EGPA).
• The previous British Society for Rheumatology (BSR) guideline for AAV management was published in 2014.
• Recent research and clinical trials offer new insights for optimizing AAV patient care and quality of life.

Purpose of the Study:

• To update the 2014 BSR and British Health Professionals in Rheumatology (BHPR) guideline for adult AAV management.
• To provide evidence-based recommendations for AAV treatment and care delivery.
• To incorporate specialist expertise and patient perspectives into AAV management strategies.

Main Methods:

• Systematic literature review of published guidelines and recent research.
• Expert consensus from the BSR AAV Working Group (WG) and UK specialist vasculitis centers.
• Inclusion of patient representatives in the guideline development process.

Main Results:

• A list of 26 updated recommendations for AAV management was formulated.
• Recommendations cover treatment for GPA, MPA, and EGPA, ENT manifestations, service specifications, and patient support.
• Strength of Agreement (SOA) scores were assigned to each recommendation.

Conclusions:

• The updated recommendations provide current evidence and specialist opinion on AAV care delivery.
• The guidelines aim to improve equitable access to care and enhance health outcomes for AAV patients.
• Research and audit recommendations are included to further advance AAV management.