Current management of eosinophilic granulomatosis with polyangiitis across Europe: insights from a multinational expert survey
Year: 2026
Type: article
Study design: Observational Study
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.
Source: Lara D. Veeken
Authors: Edoardo Conticini, Giacomo Emmi, Silvia Grazzini, Marc André, Jan Willem Cohen Tervaert, Eugenia Durante, Francesca Torracca, Aladdin J Mohammad, Frank Moosig, Thomas Neumann, Roser Solans Laque, Benjamin Terrier, Augusto Vaglio, Paolo Cameli, the European EGPA Study Group (EESG), Diego Bagnasco, Francesco Benvenuti, Alvise Berti, Milena Bond, Marco Caminati, Giulia Cassone, Francesco Cianci, Laura Coladonato, Fabrizio Conti, Christian Dejaco, Stefano Del Giacco, Paolo Delvino, Francesco Ferro, Marco Folci, Alberto Lo Gullo, Giuseppe Guida, Mario Malerba, Riccardo Mancini, Alessandra Milanesi, Sara Monti, Gianluca Moroncini, Luca Moroni, Santi Nolasco, Silvia Noviello, Paola Parronchi, Roberto Padoan, Stefano Pizzimenti Hissaria Pravin, Beatrice Ragnoli, Francesca Regola, Luisa Ricciardi, Barbara Ruaro, Lorenzo Salvati, Jan Walter Volk Schroeder, Savino Sciascia, Marco Sebastiani, Paola Tomietto
Institutions: University of Siena, University of Trieste, Ospedale di Cattinara, Centre Hospitalier Universitaire de Clermont-Ferrand, University of Alberta, Maastricht University, Lund University, University of Cambridge, University Hospital Schleswig-Holstein, Kantonsspital St. Gallen, Vall d'Hebron Hospital Universitari, Inserm, Université Paris Cité, Hôpital Cochin, Assistance Publique – Hôpitaux de Paris, Paris Cardiovascular Research Center, Meyer Children's Hospital, University of Florence
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,597
OpenAlex ID: W7155183082
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