Biological drugs in ANCA-associated vasculitis

Int Immunopharmacol. 2015 Aug;27(2):209-12. doi: 10.1016/j.intimp.2015.04.023. Epub 2015 Apr 20.


The anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitides granulomatosis with polyangiitis (GPA), eosinophilic granulomatosis with polyangiitis (EGPA) and microscopic polyangiitis (MPA) constitute a wide spectrum of clinical manifestations of systemic vasculitis which may range from limited disease to organ or life-threatening disease. The introduction of biologics for the management of severe ANCA-associated vasculitis and severe, relapsing disease refractory to conventional immunosuppressants, has significantly improved the clinical prognosis of these autoimmune disorders. Rituximab, an anti-CD20 monoclonal antibody is licenced for remission induction in severe GPA and MPA and the management of severe relapsing, refractory GPA and MPA. Belimumab, an anti-B lymphocyte stimulatory monoclonal antibody is in clinical trials for the management of the ANCA-associated vasculitis GPA. Mepolizumab and Omalizumab are biologics which have been reported to be efficacious in refractory asthma associated with EGPA. The role of anti-TNF therapy and T cell targeting drugs in ANCA-associated vasculitis is less clear due to limited study data. This review will summarise the clinical trials and clinical practice use of biologic treatment strategies for the management of ANCA-associated vasculitis.

Keywords: ANCA; Biologics; Monoclonal antibodies; Rituximab; Vasculitis.

Publication types

  • Review

MeSH terms

  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / drug therapy*
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Biological Products / therapeutic use*
  • Humans
  • Immunologic Factors / therapeutic use
  • Omalizumab / therapeutic use
  • Rituximab / therapeutic use
  • T-Lymphocytes / immunology
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors


  • Antibodies, Monoclonal, Humanized
  • Biological Products
  • Immunologic Factors
  • Tumor Necrosis Factor-alpha
  • Omalizumab
  • Rituximab
  • belimumab
  • mepolizumab