Treatment of ANCA-associated vasculitis: new therapies and a look at old entities

Adv Chronic Kidney Dis. 2014 Mar;21(2):182-93. doi: 10.1053/j.ackd.2014.01.009.

Abstract

Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a small-vessel vasculitis that primarily comprises 2 clinical syndromes: granulomatosis with polyangiitis and microscopic polyangiitis. Cyclophosphamide and glucocorticoids have traditionally been used for induction of remission. However, more recent studies have shown that rituximab is as effective as cyclophosphamide for induction therapy in patients with newly diagnosed severe AAV and superior for patients with relapsing AAV. There is also accumulating evidence indicating a potential role of rituximab for maintenance therapy in AAV. In this article, we will review the evidence supporting the various treatment choices for patients with AAV.

Keywords: ANCA-associated vasculitis; Cyclophosphamide; Rituximab.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / therapy*
  • Antibodies, Monoclonal, Murine-Derived / therapeutic use*
  • Cyclophosphamide / therapeutic use*
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Mycophenolic Acid / analogs & derivatives*
  • Mycophenolic Acid / therapeutic use
  • Plasma Exchange / methods*
  • Rituximab

Substances

  • Adrenal Cortex Hormones
  • Antibodies, Monoclonal, Murine-Derived
  • Immunosuppressive Agents
  • Rituximab
  • Cyclophosphamide
  • Mycophenolic Acid