Vasculitis and biologic infusion therapies: implications for nursing

Vasculitis is a heterogeneous group of uncommon, complex rheumatologic diseases. These diseases are known for their high mortality and morbidity rates due to the underlying disorders themselves, as well as complications of their conventional treatments. Oral and intravenous glucocorticosteroids and other immunosuppressive agents such as cyclophosphamide, methotrexate, and azathioprine are used to manage these diseases. These therapies are effective, but they have a global impact (often negative) on patients' immune systems and cause a number of nonimmunologic toxicities. They also are ineffective in inducing long-term remissions. Novel biologic infusion agents such as rituximab and infliximab are being prescribed off-label for some patients with vasculitis who have failed to respond to conventional therapy or because there are contraindications to standard-of-care treatments. This article provides an orientation to vasculitis, its standard of care, infusion biologics under investigation in these diseases, and the nursing implications for infusion professionals.