What are the guideline sources, guidelines and references for Relapsing polychondritis ?
Guideline sources The following summarized guidelines for the evaluation and management of relapsing polychondritis (RP) are prepared by our editorial team based on guidelines from the American College of Rheumatology (ACR 2023), the European League Against Rheumatism (EULAR 2022), and the European Reference Network on Rare and Complex Connective Tissue and Musculoskeletal Diseases (ERN ReCONNET 2018). 1 2 3 Calculator Calculator Damiani and Levine criteria for r McAdam criteria for relapsing po Guidelines 1. Diagnostic investigations Pretreatment evaluation: screen for HBV infection in all patients eligible for treatment with conventional synthetic, biological, or targeted synthetic DMARDs, immunosuppressants, or corticosteroids (according to dose and duration). B Show 3 more https://web.pathway.md/diseases/recDywMbsc0SUjRDJ 1/3 6/24/23, 2:57 PM Relapsing polychondritis Pathway 2. Medical management General principles: take into account disease severity and patient individual characteristics to decide on the treatment strategy in patients with RP, and contact an RP center when appropriate. E Management of auricular or nasal chondritis: offer NSAIDs and corticosteroids in patients with nasal or auricular chondritis. Offer colchicine, dapsone, methotrexate, or other conventional immunosuppressive agents or biologics in patients with relapsing disease. E Management of peristernal chondritis: offer NSAIDs and corticosteroids in patients with peristernal chondritis. Offer colchicine, dapsone, methotrexate, or other conventional immunosuppressive agents or biologics in patients with relapsing disease. E Management of tracheal chondritis: offer corticosteroids, methylprednisolone infusion, conventional synthetic DMARDs, conventional immunosuppressive agents (such as cyclophosphamide), or biologics in patients with tracheal chondritis. E Management of articular involvement: offer NSAIDs, corticosteroids, conventional synthetic DMARDs, conventional immunosuppressive agents (such as methotrexate), or biologics in patients with articular manifestations and peripheral and/or axial involvement. E Management of cutaneous involvement: offer corticosteroids, colchicine, dapsone (especially in case of neutrophilic dermatitis), and methotrexate in patients with cutaneous involvement. E Management of cardiac involvement: offer corticosteroids, conventional synthetic DMARDs, conventional immunosuppressive agents (such as methotrexate), or biologics in patients with cardiac involvement (pericarditis, myocarditis, aortitis) or valvular involvement. E Management of ocular involvement: offer topical corticosteroids and cycloplegics in patients with ocular involvement (episcleritis, scleritis). Refer all patients with ocular involvement to an ophthalmologist. Consider offering conventional synthetic DMARDs, conventional immunosuppressive agents, or biologics. E Management of audiovestibular involvement: offer corticosteroids, methylprednisolone infusion, conventional synthetic DMARDs, conventional immunosuppressive agents, or biologics in patients with audiovestibular dysfunction (sensorineural deafness, vestibular dysfunction). E Management of nervous system involvement: offer corticosteroids, methylprednisolone infusion, conventional synthetic DMARDs, conventional immunosuppressive agents (such as cyclophosphamide), or biologics in patients with neurological manifestations (sensorimotor neuropathy, encephalitis). E Management of renal involvement: recognize that renal involvement in most cases suggests differential diagnoses such as antineutrophil cytoplasmic autoantibodies-associated vasculitis. E 3. Preventative measures https://web.pathway.md/diseases/recDywMbsc0SUjRDJ 2/3 6/24/23, 2:57 PM Relapsing polychondritis Pathway Routine immunizations: consider offering high-dose or adjuvanted influenza vaccination, rather than regular-dose influenza vaccination, in 65 years old patients with rheumatic or musculoskeletal diseases and in 18-65 years old patients with rheumatic or musculoskeletal diseases on immunosuppressive medications. C Show 17 more Prophylaxis for Pneumocystis jirovecii pneumonia: consider administering prophylaxis against P. jirovecii pneumonia in patients initiating high-dose corticosteroids, especially in combination with immunosuppressants and depending on the risk-benefit ratio. C References 1. Simona Rednic, Laura Damian, Rosaria Talarico et al. Relapsing polychondritis: state of the art on clinical practice guidelines. RMD Open. 2018 Oct 18;4 Suppl 1):e000788. Open 2. George E Fragoulis, Elena Nikiphorou, Mrinalini Dey et al. 2022 EULAR recommendations for screening and prophylaxis of chronic and opportunistic infections in adults with autoimmune inflammatory rheumatic diseases. Ann Rheum Dis. 2022 Nov 3;ard-2022 223335. Open 3. Anne R Bass, Eliza Chakravarty, Elie A Akl et al. 2022 American College of Rheumatology Guideline for Vaccinations in Patients With Rheumatic and Musculoskeletal Diseases. Arthritis Rheumatol. 2023 Jan 4. Online ahead of print. Open 4. L P McAdam, M A O'Hanlan, R Bluestone et al. Relapsing polychondritis: prospective study of 23 patients and a review of the literature. Medicine Baltimore). 1976 May;55 3 193 215. Open 5. J M Damiani, H L Levine. Relapsing polychondritis report of ten cases. Laryngoscope. 1979 Jun;89 6 Pt 1 929 46. Open https://web.pathway.md/diseases/recDywMbsc0SUjRDJ 3/3