Treatment of antineutrophil cytoplasmic antibody-associated vasculitis: update

J Bras Pneumol. 2011 Nov-Dec;37(6):809-16. doi: 10.1590/s1806-37132011000600016.
[Article in English, Portuguese]

Abstract

In its various forms, antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is characterized by a systemic inflammation of the small and medium-sized arteries (especially in the upper and lower respiratory tracts, as well as in the kidneys). The forms of AAV comprise Wegener's granulomatosis (now called granulomatosis with polyangiitis), microscopic polyangiitis, renal AAV, and Churg-Strauss syndrome. In this paper, we discuss the phases of AAV treatment, including the induction phase (with cyclophosphamide or rituximab) and the maintenance phase (with azathioprine, methotrexate, or rituximab). We also discuss how to handle patients who are refractory to cyclophosphamide.

Publication types

  • Review

MeSH terms

  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / drug therapy
  • Antibodies, Monoclonal, Murine-Derived / therapeutic use
  • Azathioprine / therapeutic use
  • Cyclophosphamide / therapeutic use
  • Granulomatosis with Polyangiitis / drug therapy*
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Induction Chemotherapy / methods
  • Methotrexate / therapeutic use
  • Microscopic Polyangiitis / drug therapy*
  • Rituximab
  • Time Factors

Substances

  • Antibodies, Monoclonal, Murine-Derived
  • Immunosuppressive Agents
  • Rituximab
  • Cyclophosphamide
  • Azathioprine
  • Methotrexate