Treatment of Antineutrophil Cytoplasmic Antibody-Associated Vasculitis: Is There Still a Role for Cyclophosphamide?

Sebastian E Sattui; Robert F Spiera

doi:10.1016/j.rdc.2019.04.006

Treatment of Antineutrophil Cytoplasmic Antibody-Associated Vasculitis: Is There Still a Role for Cyclophosphamide?

Rheum Dis Clin North Am. 2019 Aug;45(3):379-398. doi: 10.1016/j.rdc.2019.04.006.

Authors

Sebastian E Sattui¹, Robert F Spiera²

Affiliations

¹ Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA. Electronic address: sattuicortess@hss.edu.
² Division of Rheumatology, Department of Medicine, Weill Cornell Medical College, Scleroderma, Vasculitis & Myositis Center, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA.

PMID: 31277751
DOI: 10.1016/j.rdc.2019.04.006

Abstract

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a group of systemic necrotizing vasculitides that includes granulomatosis with polyangiitis, microscopic polyangiitis, and eosinophilic granulomatosis with polyangiitis. Treatment of these conditions has improved during the past 2 decades with better understanding of these conditions and availability of newer agents. Cyclophosphamide (CYC) was the first drug demonstrated to afford successful treatment and improvement in AAV. With the emergence of newer agents with more favorable safety profiles, CYC is no longer the cornerstone of management of AAV. This article reviews existing data for treatment and the current role of CYC in the management of AAV.

Keywords: ANCA-associated vasculitis; Cyclophosphamide; Remission induction; Rituximab; Treatment.

Publication types

Review

MeSH terms

Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / drug therapy*
Antirheumatic Agents / pharmacology
Cyclophosphamide / pharmacology*
Humans
Remission Induction / methods

Substances

Antirheumatic Agents
Cyclophosphamide