[Cortisone-free rheumatology-Vasculitides].

Abstract

Glucocorticoids (GC) still represent an essential pillar of treatment in the phase of remission induction of vasculitides, which are often organ or life-threatening; however, they entail a significant potential for side effects. In the phase of remission maintenance prednisolone should be reduced to 7.5 mg/day or less. Whether a discontinuation can alway be achieved for any form of vasculitis without increasing relapse rates, is unclear. By the use of biologics, e.g. tocilizumab in giant cell arteritis (GCA), a fast tapering and discontinuation of GC seems to be more easily achievable compared to using a GC monotherapy regimen. Avacopan could in the future be an efficient agent to spare GC in the phase of remission induction in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), e.g. granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA). Mepolizumab is a promising option to reduce the use of GC in eosinophilic granulomatosis with polyangiitis (EGPA).

• Authors: Julia U Holle, Frank Moosig
• Journal: Zeitschrift fur Rheumatologie (Z Rheumatol) Vol. 80 Issue 4 Pg. 314-321 (May 2021) ISSN: 1435-1250 [Electronic] Germany
• Vernacular Title: Kortisonfreie Rheumatologie – Vaskulitiden.
• PMID: 33709164 (Publication Type: Journal Article, Review)

Chemical References

• Antibodies, Antineutrophil Cytoplasmic

Topics

• Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis (diagnosis, drug therapy)
• Antibodies, Antineutrophil Cytoplasmic
• Churg-Strauss Syndrome
• Granulomatosis with Polyangiitis
• Humans
• Microscopic Polyangiitis
• Rheumatology