Recommendations of the Italian Society of Rheumatology for the treatment of the primary large-vessel vasculitis with biological agents.
OBJECTIVE
To provide recommendations on behalf of the Italian Society for Rheumatology for the off-label use of biologic agents in the treatment of large-vessel vasculitis.


METHODS
A panel of experts performed a literature search and selected the evidence relevant to the topic. The following five large-vessel vasculitides were considered: giant cell arteritis, Takayasu arteritis, primary angiitis of the central nervous system, Cogan's syndrome, and Adamantiades-Behçet's disease.


RESULTS
A consensus was achieved regarding the indication of biologic agents for the treatment of large-vessel vasculitis. Levels of evidence were assigned to the papers retrieved, and the strength of the recommendations was graded according to the levels of evidence.


CONCLUSIONS
These recommendations may be used for guidance in deciding which patients with large-vessel vasculitis should receive biologic therapy. Further updates of these recommendations may be published on the basis of the results of new clinical studies and of data from post-marketing surveillance.
Rheumatology Department, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy. pipitone.nicolo@asmn.re.it
Nicolò
N
Pipitone
Ignazio
I
Olivieri
Carlo
C
Salvarani
D001528:Behcet Syndrome / Q000188:drug therapy; D001688:Biological Products / Q000627:therapeutic use*; D055952:Cogan Syndrome / Q000188:drug therapy; D019317:Evidence-Based Medicine; D013700:Giant Cell Arteritis / Q000188:drug therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D056687:Off-Label Use; D018579:Patient Selection; D012219:Rheumatology / Q000592:standards*; D013625:Takayasu Arteritis / Q000188:drug therapy; D016896:Treatment Outcome; D014657:Vasculitis / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D020293:Vasculitis, Central Nervous System / Q000188:drug therapy
D001688:Biological Products; D007166:Immunosuppressive Agents