Systematic Review and Meta-Analysis for JCS 2026 Guideline on Management of Large-Vessel Vasculitis - PubMed
6 days ago
- #Large-Vessel Vasculitis
- #Systematic Review
- #Clinical Guidelines
- Systematic review and meta-analysis conducted for the 2026 Japanese Circulation Society (JCS) guideline on large-vessel vasculitis (LVV), including Takayasu arteritis (TAK) and giant cell arteritis (GCA).
- Clinical questions drafted: 4 for TAK and 7 for GCA, with a systematic review of RCTs using multiple databases up to March 2024.
- GRADE approach used to assess evidence certainty: very low for most critical outcomes, low for some, and moderate for only one outcome.
- Limited evidence for TAK; Tocilizumab (TCZ) showed a numerically lower relapse rate vs. placebo but similar to adalimumab.
- No clear difference between mycophenolate mofetil (MMF) and methotrexate (MTX), or between abatacept (ABA) and placebo in TAK.
- In GCA, TCZ reduced relapse and increased remission over placebo at 52 weeks, while tumor necrosis factor inhibitors, ABA, and MTX showed no benefit in cranial GCA.
- Serious adverse events were comparable between treatment groups, with noted geographic variation and differences in entry criteria.
- Comprehensive synthesis of RCT evidence for LVV therapies to support the 2026 JCS guideline.