Dr. Emilia Sato speaks about the process to achieve these guidelines and the benefits and impacts expected for the healthcare systems in the region.
EF: Hello everyone. Welcome to a new Global Rheumatology video blog. Today we will talk about the upcoming PANLAR 2022 and will be joined by Dr. Emilia Sato, who will discuss the Pan American guidelines on Takayasu’s arteritis. Welcome, doctor.
ES: Hello. My name is Emilia Inoue Sato. I am the chair of rheumatology at the Federal University of São Paulo, Brazil. It is a great pleasure to be here and discuss what PANLAR 2022 will be after the pandemic, the first face-to-face meeting where Latin American vasculitis guides will be presented, the first guides.
EF: How important is it that we have Pan American guides?
ES: It’s very important. Diseases, including vasculitis, have different frequencies in different populations, so the frequency of some vasculitis is different in Europe, North America, South America, and even in Latin America the frequency of some diseases is different in different countries, for example, Takayasu’s arteritis is very frequent in Brazil, but it is not in Peru.
Likewise, international guides treatments, which are basically European or American, cover diseases and treatments that do not exist in Latin America. Therefore, guidelines have to be adapted to the diseases, to the disease’s indications and also to the socioeconomic conditions of that country and to the availability of treatment.
EF: What was the process of drafting these new guides?
ES: It was similar to all the vasculitis group guidelines. We followed the Grade method, and asked the PICO (population, intervention, comparison, outcome) questions because they consider population, intervention performed, benchmark and the outcome, that is, the results. That is why they are named PICO.
We had a group of methodologists who searched the available literature based on the questions asked.
The vasculitis experts are people who work in different Latin American countries and came together to draft, and methodologists collected the literature to answer these PICO questions. Several meetings were then held among experts to decide whether they agree with any of the directions and recommendations of that group. Unfortunately, not all the issues raised have data in the literature. Therefore, we also have some recommendations based on expert opinions and not on bibliography due to the lack of papers addressing that topic or specific issue.
EF: Who involved your group as researchers in the process, in all this work?
ES: For us, it was the first Latin American guide in the area of vasculitis, and I think it was a very rich and very good experience, because we brought together groups working in the same area. We tried to understand each other and also the differences and similarities existing between different Latin American countries and in PANLAR itself, which includes North America. We had several people living here in the United States participating in this group and I think we have different understandings or different treatment conditions for the same diseases. We had to consider all this to make recommendations or guides. That was very enriching for all.
EF: How do we position as a region with these guides in terms of research and advances?
ES: The truth is that we have to try to have greater participation on the international stage. First, we must participate more, because there is a greater number of Latin American patients with their genetic background and life conditions that shall be studied when evaluating a new drug. Second, we need more studies, especially epidemiological ones, to understand differences between diseases. Here we are talking about vasculitis in different countries in this large group that is Latin America, and I think we should also have some specific studies for our population. This is a dream to work towards in the future.
This experience of drafting the guides and recommendations is to provide knowledge among us and also to acknowledge the different groups in order to work together in the future.
EF: Will this change and allow improvements in diagnosis and treatment for our population?
ES: This guide mainly addressed the treatment, we have not made a deep evaluation of diagnosis, techniques and diagnostic methods, that work is pending. But I think treatment will provide different specialists minimum knowledge about these diseases and a base for themselves to begin treatment and it will also stir people’s curiosity to read the guide and study a little more about these diseases. We hope it will bring great benefits to our patients. So, regarding the new drugs approved to treat this disease, health departments from different countries may also be interested in delivering these drugs that generally have a high cost for the population to be treated in their countries.
EF: Thank you very much for your time and explanation, doctor
ES: It was a pleasure joining you.
Vasculitis Guidelines Team:
- Babini, Alejandra
- Flores Suarez, Luis Felipe
- Inoue Sato, Emilia
- Magri, Sebastian J.
- Saldarriaga-Rivera, Lina M.
- Scolnik, Marina
- Silva de Souza, Alexandre W.
- Ugarte-Gil, Manuel F.
- Unizony, Sebastian
Team of methodologists:
- Acosta Felquer, M. Laura
- Carlevaris, Leandro
- Scarafia, Santiago
- Vergara, Facundo
- Zamora, Natalia
PANLAR research unit:
- Brance, M. Lorena
- Fernandez Avila, Daniel G.
- Soriano Guppy, Enrique R.