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Refractory disease in antineutrophil cytoplasmic antibodies associated vasculitis
Abraham Rutgers1, Cees G M Kallenberg
1Department of Rheumatology and Clinical Immunology, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands.
Purpose Of Review:
Induction treatment of antineutrophil cytoplasmic antibodies (ANCA) associated vasculitis (AAV) is not always successful and nonresponding patients are considered refractory.
Recent Findings:
Refractory disease should be subdefined to the treatment that was received. Cyclophosphamide refractory AAV occurs in up to 5% of patients. Many more patients develop contraindications to cyclophosphamide or relapse frequently. The latter two patient groups might also benefit from treatment used for cyclophosphamide refractory AAV.
Summary:
The most promising drug for treating refractory AAV is rituximab.
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