Clinical Practice Guideline for the Management of Large-Vessel Vasculitis in Colombia Colombian Association of Rheumatology

Introduction: Large-vessel vasculitis comprises chronic inflammatory diseases that affect major arteries and can lead to serious complications such as ischemia and aneurysms. In Colombia, variability in the implementation of clinical guidelines and in access to treatment highlights the need for a practice guideline adapted to the national context. Purpose: To develop recommendations based on the best available evidence for the diagnosis, treatment, and follow-up of large-vessel vasculitis in Colombia. Materials and methods: A multidisciplinary group of experts was convened, and the GRADE methodology was applied to ensure the robustness of the recommendations. Systematic reviews were conducted, and recommendations were adapted to the Colombian context, taking into account efficacy, safety, costs, and equity. Results: Recommendations were formulated for the management of patients with giant cell arteritis and Takayasu arteritis. The guideline includes recommendations on the use of glucocorticoids, conventional immunosuppressants, biologic therapies, and other treatment options, as well as considerations for surgical management and follow-up. It emphasizes the importance of individualized decision-making based on disease activity and severity, associated risk factors, patient preferences, and the availability of interventions. Conclusions: This clinical practice guideline provides recommendations to optimize the treatment and follow-up of patients with large-vessel vasculitis in Colombia, aiming to reduce variability in care, improve clinical outcomes, and support informed decision-making in the management of these patients.