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Mechanism of Kemeng Fang's Inhibition of Podocyte Apoptosis in Rats with Membranous Nephropathy through the PI3K/AKT Signaling Pathway
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Aging in Granulomatosis with Polyangiitis and Microscopic Polyangiitis: From Pathophysiology to Clinical Management
Baptiste Chevet1,2, Giulia Boscato Sopetto3, Christian Pagnoux4
1LBAI, UMR1227, Univ Brest, Inserm, Brest, France.
Drugs & Aging
|May 31, 2025
Summary
Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) affect older adults, with unique considerations for aging and frailty. Management requires balancing immunosuppression efficacy with side effects and implementing prophylactic measures.
Area of Science:
- Rheumatology
- Immunology
- Geriatrics
Background:
- Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) predominantly impact individuals aged 55-75.
- Increasing life expectancy leads to more diagnoses in patients over 75.
- Limited clinical trial data exists for older AAV patients, hindering understanding of aging's role.
Purpose of the Study:
- To explore the impact of immunosenescence and aging on AAV pathogenesis and progression.
- To highlight age-specific AAV manifestations and management challenges.
- To review current and emerging therapeutic strategies for older AAV patients.
Main Methods:
- Review of existing literature on AAV in older populations.
- Analysis of age-related factors influencing AAV presentation and treatment.
- Evaluation of clinical trial data and treatment guidelines.
Main Results:
- Older AAV patients may present with increased renal involvement and interstitial lung disease.
- Frailty is a critical factor in therapeutic decision-making for elderly patients.
- Rituximab and potentially avacopan show promise for remission induction in older AAV populations.
Conclusions:
- AAV management in older adults necessitates tailored approaches considering immunosenescence and frailty.
- Prophylactic strategies against infections and mitigation of glucocorticoid side effects are crucial.
- Further research is needed to optimize AAV treatment outcomes in the elderly.
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