[Immunosuppressive therapy of vasculitis: current aspects and perspectives]

Area of Science:

• Immunology
• Rheumatology
• Vascular Medicine

Background:

• Vasculitides encompass diverse inflammatory vessel diseases with unknown causes and varied immunopathogenesis.
• Heterogeneous clinical presentations and severity depend on affected vessels, necessitating standardized nomenclature for diagnosis and management.
• Current treatments include steroids and immunosuppressants, with advanced therapies for refractory cases.

Purpose of the Study:

• To review current understanding of vasculitides, including classification challenges and therapeutic strategies.
• To highlight the need for standardized diagnostic and remission criteria.
• To explore novel therapeutic approaches and treatment models for vasculitides.

Main Methods:

• Literature review of vasculitis classifications and therapeutic advancements.
• Analysis of immunopathogenetic mechanisms and clinical manifestations.
• Discussion of emerging treatments, including monoclonal antibodies and combination therapies.

Main Results:

• Existing classifications for vasculitides lack standardization, hindering diagnosis and patient management.
• Conventional therapies (steroids, immunosuppressants) are insufficient for all cases.
• Novel approaches involve targeted therapies and a combined treatment model, inspired by oncology, for improved outcomes.

Conclusions:

• Standardized nomenclature and activity/remission criteria are crucial for advancing vasculitis care.
• An oncological model of combined therapy may offer superior disease control and remission maintenance.
• Further research into underlying mechanisms will refine therapeutic strategies for vasculitides.