Background/Purpose: Several guidelines have been published on the diagnosis and treatment of anti-neutrophil cytoplasmic antibodies (ANCA) associated vasculitis (AAV). These guidelines provide an evidence-based approach to support clinical-decision making and adequate implementation is needed to improve care. As part of an implementation strategy, national consensus meetings in the Netherlands were initiated in order to establish consensus on broad aspects of the diagnosis and treatment of AAV based upon the recently published guidelines, relevant to daily clinical practice.

Methods: A national, multidisciplinary working group of physicians (nephrologists, rheumatologists, immunologists, pulmonologist, pathologist) with expertise on AAV addressed the broad spectrum of diagnosing, treating and organisation of care for AAV patients. Consensus was established using a Delphi-based method in a national conference in conjunction with a nationally distributed online consensus survey.  This survey was distilled from the current published international guidelines. Cut-off for consensus was 70% (dis-)agreement.

Results: Ninety-eight professionals were involved in the Delphi procedure to assess consensus on 52 statements regarding diagnosis, treatment and organisation of care for AAV patients. From 52 statements, consensus was achieved for 39 statements (75%). Consensus was achieved on aspects of AAV disease definition, nomenclature, distinct disease states through follow-up, treatment algorithm and organisation of care for AAV. No consensus was achieved on the necessity of histopathological evidence, regular blood testing for ANCAs and standard BVAS, VDI and PROMs assessment.

Conclusion: This study describes the results of a national consensus statement on diagnosing and treatment of AAV patients as part of an implementation strategy in the Netherlands of (inter-)national guideline-derived recommendations. Future studies should evaluate whether the consensus statement has facilitated local implementation, reduced clinical practice variation and, ultimately, improved care for AAV patients in the Netherlands.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/a-dutch-consensus-statement-on-the-diagnosis-and-treatment-of-anca-associated-vasculitis/