Current management of eosinophilic granulomatosis with polyangiitis across Europe: insights from a multinational expert survey

OBJECTIVES: Real-world practice patterns of eosinophilic granulomatosis with polyangiitis (EGPA) remain poorly defined. This study aimed to describe current diagnostic and therapeutic approaches across experienced European centres, identifying areas of convergence and variability to inform future standardization of care. METHODS: We distributed a 44-item online survey covering diagnostic evaluation, treatment strategies, patient-reported outcome measures (PROMs) and the role of patient advocacy groups. The survey was reviewed by an expert panel and disseminated within the European EGPA Study Group. Responses were collected anonymously between April and August 2025 for statistical analysis. RESULTS: Fifty-four experts from six countries participated, most with long-standing experience and substantial EGPA caseloads. Multidisciplinary care and screening for cardiac and renal involvement were widely adopted; histological confirmation was reported in fewer than 25% of cases. Treatment strategies varied considerably: over half of respondents initiated anti-IL-5 therapy at diagnosis, and the combination of glucocorticoids, rituximab and mepolizumab was the preferred induction regimen in severe disease. CS tapering protocols differed, with most clinicians targeting withdrawal within 12 months. PROMs and disease-specific questionnaires were used inconsistently, despite broad recognition of their value. Advocacy groups were viewed as crucial, particularly for patient education and referral. CONCLUSION: This first multinational survey reveals substantial heterogeneity in real-world diagnostic and therapeutic practice, reflecting gaps in validated criteria, standardized activity measures and treatment algorithms. These findings highlight the need for coordinated prospective research and harmonized evidence-based guidance to optimize outcomes for patients with EGPA.

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Lara D. Veeken
Published
2026-04-17
DOI
https://doi.org/10.1093/rheumatology/keag218
Primary Topic
Vasculitis and related conditions
Type
article
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article

Current management of eosinophilic granulomatosis with polyangiitis across Europe: insights from a multinational expert survey

Marco Folci, Jan Walter Volk Schroeder, Mario Malerba, Riccardo Mancini et al.
Lara D. Veeken
Vasculitis and related conditions
article

Current management of eosinophilic granulomatosis with polyangiitis across Europe: insights from a multinational expert survey

Marco Folci, Jan Walter Volk Schroeder, Mario Malerba, Riccardo Mancini, Diego Bagnasco, Alvise Berti, L. Coladonato, Paola Parronchi, Santi Nolasco, J Cohen Tervaert, Eugenia Durante, Frank Moosig, Alessandra Milanesi, Barbara Ruaro, Milena Bond, Fabrizio Conti, Giuseppe Guida, Beatrice Ragnoli, Lorenzo Salvati, Luca Moroni, Francesca Regola, Edoardo Conticini, Giulia Cassone, Francesca Torracca, Silvia Noviello, Sara M. Monti, Alberto Lo Gullo, Christian Dejaco, Paolo Delvino, Francesco Cianci, Francesco Ferro, Roser Solans Laqué, Paola Tomietto, A M Mohammad, Stefano Giacco, Benjamin Terrier, Gianluca Moroncini, Marc André, Stefano Pizzimenti Hissaria Pravin, Augusto Vaglio, Francesco Benvenuti, Paolo Cameli, Giacomo Emmi, Savino Sciascia, Silvia Grazzini, Marco Sebastiani, Roberto Padoan, Marco Caminati, the European EGPA Study Group (EESG), Luisa Ricciardi, Thomas Neumann
article en

Abstract

OBJECTIVES: Real-world practice patterns of eosinophilic granulomatosis with polyangiitis (EGPA) remain poorly defined. This study aimed to describe current diagnostic and therapeutic approaches across experienced European centres, identifying areas of convergence and variability to inform future standardization of care. METHODS: We distributed a 44-item online survey covering diagnostic evaluation, treatment strategies, patient-reported outcome measures (PROMs) and the role of patient advocacy groups. The survey was reviewed by an expert panel and disseminated within the European EGPA Study Group. Responses were collected anonymously between April and August 2025 for statistical analysis. RESULTS: Fifty-four experts from six countries participated, most with long-standing experience and substantial EGPA caseloads. Multidisciplinary care and screening for cardiac and renal involvement were widely adopted; histological confirmation was reported in fewer than 25% of cases. Treatment strategies varied considerably: over half of respondents initiated anti-IL-5 therapy at diagnosis, and the combination of glucocorticoids, rituximab and mepolizumab was the preferred induction regimen in severe disease. CS tapering protocols differed, with most clinicians targeting withdrawal within 12 months. PROMs and disease-specific questionnaires were used inconsistently, despite broad recognition of their value. Advocacy groups were viewed as crucial, particularly for patient education and referral. CONCLUSION: This first multinational survey reveals substantial heterogeneity in real-world diagnostic and therapeutic practice, reflecting gaps in validated criteria, standardized activity measures and treatment algorithms. These findings highlight the need for coordinated prospective research and harmonized evidence-based guidance to optimize outcomes for patients with EGPA.

Lara D. VeekenVol. 65(5)
University of Siena (IT), Hebron University (PS), University of Trieste (IT), University of Alberta (CA), Inserm (FR), Nara University (JP), Lund University (SE), University of St.Gallen (CH), Université Paris Cité (FR), University of Cambridge (GB), University of Alberta Hospital (CA), Maastricht University (NL), Sorbonne Paris Cité (FR), Hôpital Cochin (FR), Ospedale di Cattinara (IT), Assistance Publique – Hôpitaux de Paris (FR), Universitäres Kinderwunschzentrum Lübeck (DE), Meyer Children's Hospital (IL), University Hospital Schleswig-Holstein (DE), Meyer Children's Hospital (IT), Vall d'Hebron Hospital Universitari (ES), Associazione Regionale Allevatori della Lombardia (IT), Centre Hospitalier Universitaire de Clermont-Ferrand (FR), Paris Cardiovascular Research Center (FR), University of Florence (IT), University of Lübeck (DE)
Partnerships for the goals
Openalex Percentile: Top 22%
Vasculitis and related conditions
DOIOpen Access PDFOpenAlex
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