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[ANCA-associated vasculitis]

J U Holle1

  • 1Klinik für Rheumatologie und Immunologie, Klinikum Bad Bramstedt, Oskar-Alexander Str. 26, 24576, Bad Bramstedt, Deutschland, j.holle@klinikumbb.de.

Der Internist
|December 16, 2014
PubMed

Insights

ANCA-associated vasculitides (AAV) involve small-vessel inflammation and may be diagnosed without ANCA antibodies. Treatment focuses on remission induction and maintenance using conventional immunosuppressants and newer options like rituximab.

Area of Science:

  • Rheumatology
  • Immunology
  • Internal Medicine

Context:

  • Vasculitides are systemic rheumatic diseases affecting various vessel sizes.
  • ANCA-associated vasculitides (AAV) encompass granulomatosis with polyangiitis, microscopic polyangiitis, and eosinophilic granulomatosis with polyangiitis.
  • These conditions manifest in small- to medium-sized vessels across organ systems.

Purpose:

  • To outline the classification and diagnostic considerations for vasculitides.
  • To describe the treatment principles for ANCA-associated vasculitides.
  • To highlight the evolving therapeutic landscape, including novel agents.

Summary:

  • AAV are characterized by inflammation of small- to medium-sized vessels and may present with or without detectable anti-neutrophil cytoplasmic antibodies (ANCA).
  • Treatment strategies are guided by disease activity and stage, involving remission induction followed by maintenance therapy.
  • Established treatments include glucocorticoids and conventional immunosuppressants, with rituximab recognized as a significant advancement since 2013.

Impact:

  • Improved understanding of AAV classification and diagnostic nuances.
  • Standardized treatment approaches based on clinical trial evidence.
  • Integration of targeted therapies like rituximab into AAV management protocols.

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