Establishing clinical remission criteria and the framework of a treat-to-target algorithm for Takayasu arteritis: Results of a Delphi exercise carried out by an expert panel of the Japan Research Committee of the Ministry of Health, Labour and Welfare for intractable vasculitis

Takahiko Sugihara, Yoshikazu Nakaoka, Haruhito A. Uchida, Hajime Yoshifuji, Yasuhiro Maejima, Yoshiko Watanabe, Eisuke Amiya, Kazuo Tanemoto, Tetsuro Miyata, Natsuka Umezawa, Yusuke Manabe, Jun Ishizaki, Tsuyoshi Shirai, Hiroko Nagafuchi, Hitoshi Hasegawa, Takako Miyamae, Hiroaki Niiro, Shuichi Ito, Tomonori Ishii, Mitsuaki IsobeMasayoshi Harigai

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

Objectives: To develop a proposal for remission criteria and a framework for a treat-to-target (T2T) algorithm for Takayasu arteritis (TAK). Methods: A study group of the large-vessel vasculitis group of the Japanese Research Committee of the Ministry of Health, Labour and Welfare for Intractable Vasculitis consists of 10 rheumatologists, 5 cardiologists, 1 nephrologist, 1 vascular surgeon, 1 cardiac surgeon, and 2 paediatric rheumatologists. A Delphi survey of remission criteria items was circulated among the study group over four reiterations. To develop the T2T algorithm, the study group conducted four face-to-face meetings and two rounds of Delphi together with three patients. Results: Initial literature review resulted in a list of 117 candidate items for remission criteria, of which 56 items with a mean score of ≥4 (0–5) were extracted including disease activity domains and treatment/comorbidity domains. The study group provided six overarching principles for the T2T algorithm, two recommendations on treatment goals, five on evaluation of disease activity and imaging findings including positron emission tomography–computed tomography, and two on treatment intensification. Conclusions: We developed a T2T algorithm and proposals for standardised remission criteria by means of a Delphi exercise. These will guide future evaluation of different TAK treatment regimens.

Original languageEnglish
Pages (from-to)930-937
Number of pages8
JournalModern Rheumatology
Volume32
Issue number5
DOIs
Publication statusPublished - Sept 1 2022

Keywords

  • Delphi exercise
  • Takayasu arteritis
  • remission criteria
  • treat-to-target algorithm

ASJC Scopus subject areas

  • General Medicine

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