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Treatment

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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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

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