Recent advances to achieve remission induction in antineutrophil cytoplasmic antibody-associated vasculitis

Research output: Contribution to journalReview article

Colleges, School and Institutes

Abstract

Purpose of review Significant advances in the treatment of antineutrophil cytoplasmic antibody-associated vasculitis have been made in the past 10 years. This review aims to detail advances in treatment aimed at induction of remission. Recent findings Cyclophosphamide-based regimes remain the standard of care, at least in generalized disease. Safer therapeutic regimes with reduced cumulative dose of cyclophosphamide have been developed such as the use of pulsed cyclophosphamide. Preliminary data are available, suggesting rituximab may be an alternative to cyclophosphamide, but additional safety data are required. Evidence suggests that plasma exchange should be added to those with more severe disease and it is acceptable to use methotrexate as an induction agent for those with limited or early systemic disease. Using current regimens, remission is achieved in over 90% of patients, but toxicity remains an important issue. Attention should be paid to reducing treatment toxicity. Summary Findings of recent clinical trials should change clinical practice and improve outcome of patients with antineutrophil cytoplasmic antibody-associated vasculitis.

Details

Original languageEnglish
Pages (from-to)37-42
Number of pages6
JournalCurrent Opinion in Rheumatology
Volume22
Issue number1
Publication statusPublished - 1 Jan 2010

Keywords

  • antineutrophil cytoplasmic antibody, treatment, Wegener's granulomatosis, vasculitis