The outcome of systemic necrotizing vasculitides, with treatment, has improved over the past few decades, with a 5 year survival rate that currently exceeds 80%. It is now well established that therapy has to be adapted to aetiology, pathogenesis and disease severity, but complementary measures can also be beneficial, for example systematic prophylaxis against infections and/or adjusting drug doses to biological parameters and the patient's general condition, especially for the elderly and those in intensive care units. A multifaceted and point-by-point approach to patient care is needed to further improve quality of life whenever possible.