Insights from Portuguese Nephrologists and Rheumatologists Concerning the Treatment of ANCA Vasculitis

Authors

  • Inês Ferreira Department of Medicine. Faculdade de Medicina. Universidade do Porto. Porto; Departament of Nephrology. Hospital de São João. Unidade Local de Saúde de São João. Porto.
  • Ana Águeda Department of Rheumatology. Hospital Pêro da Covilhã. Unidade Local de Saúde da Cova da Beira. Covilhã.
  • Carolina Belino Department of Rheumatology. Hospital Pêro da Covilhã. Unidade Local de Saúde da Cova da Beira. Covilhã.
  • Bruno Schau CSL Vifor. Lisboa.
  • João Rovisco Department of Rheumatology. Hospitais da Universidade de Coimbra. Unidade Local de Saúde de Coimbra. Coimbra.
  • Carina Ferreira Department of Nephrology. Hospital Curry Cabral. Unidade Local de Saúde de São José. Lisbon; NOVA Medical School. Universidade NOVA de Lisboa. Lisbon.

DOI:

https://doi.org/10.20344/amp.21635

Keywords:

Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/drug therapy, Nephrologists, Practice Patterns, Physicians, Rheumatologists

Abstract

Introduction: Antineutrophilic cytoplasmic antibodies-associated vasculitis (AAV) encompasses granulomatosis with polyangiitis, microscopic polyangiitis, and eosinophilic granulomatosis with polyangiitis. These rare diseases are characterized by an exaggerated immune response in blood vessels, leading to inflammation, vascular injury, ischemia, and necrosis of affected tissues and organs. Despite the existence of European recommendations for treating AAV, their implementation in Portugal remains unclear.
Methods: To address this gap, an online Delphi panel was conducted involving 55 Portuguese nephrologists and rheumatologists, representing the main specialties involved in the management of AAV. The primary objective was to assess the level of consensus regarding the treatment of AAV in Portugal and the application of European recommendations in daily clinical practice. The specialists evaluated 29 statements formulated by a group of Portuguese experts with extensive experience in AAV, addressing key aspects of AAV management, rated on a 4-point Likert scale. Consensus was defined as > 70% of responses either strongly agreeing or strongly disagreeing with a statement, while the majority level required > 70% agreement or disagreement.
Results: After one round, no statement reached consensus globally, and eight out of the 29 statements did not achieve a qualified majority. Nonetheless, this study demonstrates a high level of agreement within each medical specialty, due to the distinct characteristics of the patient populations treated by each specialty. While the results suggest partial adherence to European recommendations, they also highlight the need to standardize clinical practices for AAV treatment in Portugal.
Conclusion: This study underscores the importance of aligning national practices with established European recommendations to ensure the best outcomes for patients with AAV.

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Published

2024-11-04

How to Cite

1.
Ferreira I, Águeda A, Belino C, Schau B, Rovisco J, Ferreira C. Insights from Portuguese Nephrologists and Rheumatologists Concerning the Treatment of ANCA Vasculitis. Acta Med Port [Internet]. 2024 Nov. 4 [cited 2024 Nov. 5];37(11):778-86. Available from: https://actamedicaportuguesa.com/revista/index.php/amp/article/view/21635

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