Advances in therapy for ANCA-associated vasculitis

Research output: Contribution to journalArticle

Abstract

The anti-neutrophil cytoplasmic antibodyassociated vasculitides include granulomatosis with polyangiitis (Wegener's granulomatosis) and microscopic polyangiitis. The introduction of therapy with cytotoxic agents such as cyclophosphamide transformed these diseases from fatal diagnoses to chronic conditions characterized by cycles of relapse and remission. Modern treatment strategies have focused on minimizing cyclophosphamide exposure or eliminating its use altogether. Two randomized clinical trials have shown that rituximab is not inferior to cyclophosphamide for induction of remission in patients with severe granulomatosis with polyangiitis (Wegener's) or microscopic polyangiitis. For patients with non-life threatening disease, methotrexate may be used to induce and maintain remission, although some patients may have a higher long-term risk of relapse as a result. For patients with life-threatening disease, plasma exchange may be an effective adjuvant therapy. This article reviews seminal studies from the past decade that have contributed to the current standard of care.

Original languageEnglish (US)
Pages (from-to)509-515
Number of pages7
JournalCurrent Rheumatology Reports
Volume14
Issue number6
DOIs
StatePublished - Dec 2012

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Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis
Granulomatosis with Polyangiitis
Microscopic Polyangiitis
Cyclophosphamide
Remission Induction
Recurrence
Plasma Exchange
Cytotoxins
Therapeutics
Standard of Care
Vasculitis
Methotrexate
Neutrophils
Randomized Controlled Trials

Keywords

  • ANCA
  • ANCA-associated vasculitis
  • Biological therapy
  • Cyclophosphamide
  • Granulomatosis with polyangiitis
  • Microscopic polyangiitis
  • Plasma exchange
  • Remission
  • Therapy
  • Treatment
  • Wegener's granulomatosis

ASJC Scopus subject areas

  • Rheumatology

Cite this

Advances in therapy for ANCA-associated vasculitis. / Geetha, Duvuru; Seo, Philip.

In: Current Rheumatology Reports, Vol. 14, No. 6, 12.2012, p. 509-515.

Research output: Contribution to journalArticle

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