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Clinical Trials

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In Silico Clinical Trials for Cardiovascular Disease

In Silico Clinical Trials for Cardiovascular Disease

Published on: May 27, 2022

Clinical Trials in Vasculitis.

Seerapani Gopaluni¹, David Jayne¹

¹Lupus and Vasculitis Clinic, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, CB2 0QQ UK.

Current Treatment Options in Rheumatology

|September 23, 2017

Summary

This summary is machine-generated.

Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) treatment involves induction and maintenance phases. Clinical trials guide options like cyclophosphamide, rituximab, and glucocorticoids, improving patient outlooks.

Keywords:

ANCA ANCA-associated vasculitis Azathioprine Clinical trials Cyclophosphamide Glucocorticoids Mycophenolate mofetil Plasma exchange Rituximab Treatment Vasculitis

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Area of Science:

Rheumatology and Immunology
Clinical Trials and Therapeutics

Background:

Systemic vasculitides are rare, complex inflammatory diseases of blood vessels with limited treatment evidence.
International collaboration has enabled clinical trials, particularly in Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV).
Understanding AAV pathogenesis and biomarkers remains incomplete, highlighting the need for evidence-based treatment strategies.

Purpose of the Study:

To review current treatment options for AAV based on clinical trial evidence.
To discuss induction and maintenance therapy strategies tailored to disease severity.
To highlight advancements and remaining questions in optimizing AAV management.

Main Methods:

Review of clinical trial data for Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) treatments.
Analysis of evidence for induction therapies including cyclophosphamide, rituximab, plasma exchange, and IVIGs.
Evaluation of maintenance therapies such as azathioprine, methotrexate, mycophenolate mofetil, and rituximab.

Main Results:

Cyclophosphamide and high-dose glucocorticoids are standard for AAV induction in generalized disease.
Rituximab is an effective alternative to cyclophosphamide, especially for relapsing or intolerant patients.
Azathioprine or methotrexate are preferred for maintenance; mycophenolate mofetil is an alternative. Rituximab use in maintenance is increasing.

Conclusions:

Treatment for AAV is stratified into induction and maintenance phases, guided by disease severity and clinical trial outcomes.
Significant progress has been made, with rituximab offering a key alternative and increasing use in both induction and maintenance.
Optimal AAV treatment strategies require further research to address remaining unanswered questions.