Current therapies for ANCA-associated vasculitis

Annu Rev Med. 2015:66:227-40. doi: 10.1146/annurev-med-011514-023051. Epub 2014 Oct 17.

Abstract

The ANCA-associated vasculitides, granulomatosis with polyangiitis (GPA, formerly Wegener's), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (EGPA, formerly Churg-Strauss), are a group of multisystem autoimmune diseases characterized by necrotizing small- to medium-vessel vasculitis and the presence of anti-neutrophil cytoplasmic antibodies. Current therapeutic strategies consist of glucocorticoids in conjunction with either conventional or biologic agents for both induction of remission and remission maintenance. Treatment goals include reducing toxicity of induction therapy, preventing disease relapse, and limiting overall accrual of both disease-related damage and treatment-related morbidity. Future research directions include investigation of the optimal duration and frequency of maintenance therapy as well as development of targeted therapeutic agents, which is enhanced by emerging insights into disease pathogenesis.

Keywords: biologics; eosinophilic granulomatosis with polyangiitis (Churg-Strauss); granulomatosis with polyangiitis (Wegener's); microscopic polyangiitis.

Publication types

  • Review

MeSH terms

  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / therapy*
  • Antirheumatic Agents / therapeutic use*
  • Glucocorticoids / therapeutic use*
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Induction Chemotherapy
  • Maintenance Chemotherapy
  • Plasma Exchange / methods*

Substances

  • Antirheumatic Agents
  • Glucocorticoids
  • Immunosuppressive Agents