Systematic Review and Meta-Analysis for JCS 2026 Guideline on Management of Large-Vessel Vasculitis
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- Shirai Tsuyoshi
- Department of Rheumatology, Tohoku University Hospital
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- Yoshida Tsuneyasu
- Cedars-Sinai Medical Center, Kao Autoimmunity Institute
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- Sugano Eri
- Department of Rheumatology, Tokyo Women’s Medical University Hospital
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- Hiwa Ryosuke
- Department of Clinical Immunology, Graduate School of Medicine, Kyoto University
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- Ishihara Ryuhei
- Department of Clinical Rheumatology, Osaka Metropolitan University Graduate School of Medicine
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- Yanai Ryo
- Division of Rheumatology, Department of Medicine, Showa Medical University School of Medicine
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- Yajima Nobuyuki
- Division of Rheumatology, Department of Medicine, Showa Medical University School of Medicine
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- Kida Takashi
- Inflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
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- Nishioka Norihiro
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine
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- Sakai Ryota
- Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University
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- Handa Takaya
- Department of Nephrology, Tazuke Kofukai Medical Research Institute, Kitano Hospital
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- Honda Manabu
- Department of Rheumatology, Shimane University Faculty of Medicine
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- Ishizaki Jun
- Department of Hematology, Clinical Immunology and Infectious Diseases, Ehime University Graduate School of Medicine
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- Kadoba Keiichiro
- Department of Clinical Immunology, Graduate School of Medicine, Kyoto University
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- Kamiyama Yuji
- Department of Pediatric Rheumatology, Yokohama City University Hospital
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- Kidoguchi Genki
- Department of Clinical Immunology and Rheumatology, Hiroshima University Hospital
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- Kiko Takatoyo
- Department of Cardiovascular Medicine, Fukushima Medical University
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- Kobayashi Daisuke
- Division of Clinical Nephrology and Rheumatology, Kidney Research Center, Niigata University Graduate School of Medical and Dental Sciences
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- Kobayashi Kazuhiro
- Department of Diagnostic Pathology, Fujita Health University
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- Nakagama Shun
- Department of Virology, Graduate School of Medicine, Osaka Metropolitan University
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- Nakano Yu
- Department of Cardiovascular Surgery, Tokyo Medical University
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- Sanada Hajime
- Department of Rheumatology, Kanazawa University Hospital
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- Tamechika Shin-ya
- Division of Rheumatology, Department of Internal Medicine, Nagoya City University Hospital Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences
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- Ueda Jin
- Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital Department of Pulmonary Circulation, National Cerebral and Cardiovascular Center
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- Nagasaka Kenji
- Institute of Science Tokyo Department of Rheumatology, Ome Medical Center
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- Sugihara Takahiko
- Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine
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- Tamura Naoto
- Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine
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- Nakaoka Yoshikazu
- Department of Vascular Physiology, National Cerebral and Cardiovascular Center
書誌事項
- 公開日
- 2026-02-14
- 資源種別
- journal article
- バージョン
- 2
- DOI
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- 10.1253/circj.cj-25-1129
- 公開者
- 一般社団法人 日本循環器学会
この論文をさがす
説明
<p>Background: To provide evidence from randomized controlled trials (RCTs) for large-vessel vasculitis (LVV), including Takayasu arteritis (TAK) and giant cell arteritis (GCA), to inform the forthcoming 2026 Japanese Circulation Society (JCS) clinical practice guideline.</p><p>Methods and Results: We drafted 4 and 7 clinical questions for TAK and GCA, respectively. A systematic review (SR) of RCTs was conducted using PubMed, CENTRAL, EMBASE, and the Japan Medical Abstracts Society through March 2024. Assessed with the GRADE approach, the certainty of evidence was very low for the most critical outcomes, low for some outcomes, and moderate for only 1 outcome. Evidence for TAK was limited. Tocilizumab (TCZ) resulted in a numerically lower relapse rate vs. placebo (risk ratio (RR) 0.73, 95% confidence interval (CI) 0.39–1.37) and was similar to adalimumab. No clear difference between mycophenolate mofetil (MMF) and methotrexate (MTX), or between abatacept (ABA) and placebo was observed. In GCA, TCZ reduced relapse (RR 0.29, 95% CI 0.09–0.98) and increased remission (RR 3.56, 95% CI 2.29–5.54) over placebo at 52 weeks. Tumor necrosis factor inhibitor, ABA, and MTX showed no benefit in cranial GCA. Serious adverse events were comparable between treatment groups. Geographic variation and differences in entry criteria were noted.</p><p>Conclusions: This SR was comprehensive synthesis of evidence from RCTs for LVV therapies to support the 2026 JCS guideline.</p>
収録刊行物
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- Circulation Journal
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Circulation Journal advpub (0), 2026-02-14
一般社団法人 日本循環器学会
