Real-world clinical decisions of physicians in the management of Takayasu arteritis and giant cell arteritis in Japan: A cross-sectional web questionnaire survey

Mod Rheumatol. 2024 Oct 15;34(6):1194-1201. doi: 10.1093/mr/roae034.

Abstract

Objectives: The aim is to access the real-world clinical management of physicians who treat Takayasu arteritis (TAK) and giant cell arteritis (GCA) after the publication of the Japanese Circulation Society (JCS) 2017 Guidelines for the Management of Vasculitis Syndrome.

Methods: This descriptive, cross-sectional study utilized self-administered electronic questionnaires, which were answered in February 2022 by physicians treating TAK or GCA and registered with Macromill Inc.

Results: The 329 survey respondents were enrolled. The 2017 JCS Guidelines were the most commonly referenced information source for resolving clinical questions, accessed by 70% of respondents. Ophthalmoscopy was performed in only 50% of patients with TAK and in 70% for GCA. The median percentages of patients who underwent 18F-fluorodeoxyglucose-positron emission tomography/computed tomography for TAK and GCA patients were 23% and 20% at diagnosis, respectively, and 10% each at follow-up within 12 months. Tocilizumab was the most frequently used medication in combination with glucocorticoids for both TAK and GCA, especially in remission induction therapy for relapsed patients.

Conclusions: The majority of physicians treating TAK and GCA referred to the 2017 JCS guidelines. This report clarified the current clinical practice for large vessel vasculitis in Japan, providing information for the next revision of the guidelines.

Keywords: Clinical practice guideline; Takayasu arteritis; giant cell arteritis; large vessel vasculitis; real-world clinical decision.

MeSH terms

  • Adult
  • Antibodies, Monoclonal, Humanized
  • Clinical Decision-Making
  • Cross-Sectional Studies
  • Female
  • Giant Cell Arteritis* / diagnosis
  • Giant Cell Arteritis* / diagnostic imaging
  • Giant Cell Arteritis* / drug therapy
  • Glucocorticoids / therapeutic use
  • Humans
  • Japan
  • Male
  • Middle Aged
  • Practice Patterns, Physicians' / statistics & numerical data
  • Surveys and Questionnaires
  • Takayasu Arteritis* / diagnosis
  • Takayasu Arteritis* / diagnostic imaging
  • Takayasu Arteritis* / drug therapy

Substances

  • Glucocorticoids
  • tocilizumab
  • Antibodies, Monoclonal, Humanized