Outcomes and compliance with standards of care in anti-neutrophil cytoplasmic antibody–associated vasculitis—insights from a large multiregion audit

Abstract

OBJECTIVES: We aimed to conduct a large audit of routine care for patients with ANCA-associated vasculitis. METHODS: We invited all 34 hospitals within one health region in England to undertake a retrospective case note audit of all patients newly diagnosed or treated with CYC or rituximab (RTX) for ANCA-associated vasculitis from April 2013 to December 2014. We compared clinical practice to the British Society for Rheumatology guidelines for the management of adults with ANCA-associated vasculitis and the use of RTX with the National Health Service (NHS) England commissioning policy and National Institute for Health and Care Excellence (NICE) technology appraisal. RESULTS: pneumonia prophylaxis (recommended in the summary of product characteristics) was given in only 65% of patients. CONCLUSION: We identified opportunities to improve care, including compliance with safety standards for delivery of CYC. Development of a national treatment protocol/checklist to reduce this heterogeneity in care should be considered as a priority.