Treatment of systemic vasculitis

This review will attempt to summarize the most potentially impactful new data on the treatment of systemic vasculitic conditions, including ANCA-associated vasculitis (AAV), giant cell arteritis, polymyalgia rheumatica and Takayasu arteritis.

Rituximab, cyclophosphamide, upadacitinib, baricitinib, mepolizumab, benralizumab and tocilizumab have all had new clinical trials and observational data from real world registries showing their treatment benefit in various vasculitic conditions. The recently developed classification criteria for five different vasculitic conditions (AAV, giant cell arteritis, and Takayasu arteritis), very important for clinical trial recruitment, have serious methodological issues that continue to be present in the new criteria sets and these need to be addressed before they can be widely adopted.

Important new data over the last several years for the treatment of systemic vasculitis have the potential to change how these conditions are managed. The remaining issues outlined in this review still need to be addressed to best serve vasculitis patients.