Treatment

Seek expert advice.

Management

• induction treatment for most patients with ANCA associated vasculitis (AAV) should be with cyclophosphamide or rituximab and glucocorticoids
• AAV should be considered to be a chronic disease needing longterm immunosuppressive therapy
• rituximab should be considered as an alternative induction agent for those at high risk of infertility and infection
• mortality remains high, and late death is due to cardiovascular disease, infection (secondary to treatment) and malignancy

Notes:

• role of serial ANCA measurement in determining treatment during remission remains controversial
• some current evidence suggests patients in whom ANCA remains present or rises more than fourfold are at greater risk of relapse.

Reference:

• Davies DJ. Small vessel vasculitis. Cardiovascular Pathology 2005; 14 (6): 335-346.
• ARC Autumn 2012. Topical Reviews - ANCA-associated vasculitis; 1:1-12.
• Yates A, Watts R. ANCA-associated vasculitis. Clinical Medicine 2017 Vol 17, No 1: 60–4