Managing ANCA-associated vasculitis during the COVID-19 pandemic: results from an online survey

Area of Science:

• Rheumatology
• Immunology
• Infectious Diseases

Background:

• ANCA-associated vasculitis (AAV) management presents unique challenges during pandemics like COVID-19.
• Physician treatment choices for AAV during the COVID-19 pandemic required careful consideration of immunosuppression and infection risks.

Purpose of the Study:

• To investigate and understand the therapeutic choices made by physicians for treating AAV patients during the COVID-19 pandemic.
• To document physician preferences for immunosuppressive agents, COVID-19 testing, and preventive measures in AAV management.

Main Methods:

• An online, web-based survey with 19 questions was distributed to physicians across various specialties.
• Data collected included responses on remission induction and maintenance therapies, COVID-19 testing protocols, and preventive strategies for AAV patients.

Main Results:

• 304 responses were analyzed, predominantly from Indian rheumatologists with over 5 years of experience.
• Rituximab and intravenous cyclophosphamide were common for remission induction, with oral cyclophosphamide and mycophenolate mofetil also used.
• Only one-third of physicians tested for COVID-19 before initiating immunosuppression in severe cases. Rituximab was the preferred maintenance therapy.

Conclusions:

• Physician choices for AAV management during the COVID-19 pandemic reflected real-world dilemmas and varied approaches to immunosuppression and testing.
• The survey highlights the need for clear guidelines on managing AAV in the context of infectious disease outbreaks.