Early glucocorticoid withdrawal in severe ANCA-associated vasculitis treated with combination cyclophosphamide and...

Glucocorticoid (GC)-related toxicity remains a major challenge in anti-neutrophil cytoplasm antibody-associated vasculitis (AAV). We report five cases of newly diagnosed severe AAV treated with combination cyclophosphamide and rituximab, with the goal of ceasing GCs within 4 weeks. All patients achieved complete remission, with one relapse during follow-up. All remained GC-free at a median follow-up of 12 months. The regimen was well tolerated despite severe renal impairment. These findings support the feasibility of early GC withdrawal in organ-threatening AAV.