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The systemic vasculitides are a group of rare, chronic, relapsing, but often progressive inflammatory conditions. They are associated with a significant burden of morbidity both due to scarring from the disease itself and as a consequence of treatment with glucocorticoids and other potent immunosuppressive agents. Careful assessment of disease activity is critical to guide appropriate use of these potentially toxic therapies. It is also important to differentiate features of active disease from those attributable to damage, which will not respond to immunosuppression. As these are chronic complex conditions, the impact on a patient's functional ability and quality of life are also important considerations. Given the lack of a reliable biomarker for assessment of disease activity or damage in systemic vasculitis, clinical tools developed and validated for use initially in clinically trials are key outcome measures in the evaluation of these patients. While the conduct of randomised clinical trials in vasculitis has been significantly enhanced by the development and use of validated outcome measures, regular use of validated disease activity and damage measurements as part of routine care offers a structured approach, which can serve as the basis of justifying treatment decisions. The authors review the concepts of clinical assessment tools used in the evaluation of patients with systemic vasculitis in the setting of clinical practice, clinical trials and long term databases with particular emphasis on disease activity, damage, prognosis and function.

Type

Journal article

Journal

Clinical and experimental rheumatology

Publication Date

09/2014

Volume

32

Addresses

Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, UK; and Department of Rheumatology, Hospital de Santa Maria, Lisbon Academic Medical Centre, Lisbon, Portugal.

Keywords

Humans, Vasculitis, Disability Evaluation, Treatment Outcome, Health Status Indicators, Severity of Illness Index, Reproducibility of Results, Predictive Value of Tests, Health Status, Quality of Life, Critical Pathways, Clinical Trials as Topic, Databases as Topic, Surveys and Questionnaires, Observational Studies as Topic