ABSTRACT

Introduction: ANCA-associated vasculitis (AAV) is a group of life-threatening autoimmune conditions that require a combination of treatments for induction and maintenance therapy. High-dose glucocorticoids and cyclophosphamide have traditionally been the mainstay of AAV treatment. During the last decade, rituximab has proven to be an effective alternative to cyclophosphamide. Currently, significant research in alternative therapeutic options for both induction and maintenance treatment is underway.

Areas covered: Guideline review of remission, induction, and maintenance therapy of AAV. Examination of current research on alternative advanced therapeutics, specifically, the evidence for rituximab, C5a inhibitors, and trimethoprim-sulfamethoxazole.

Expert opinion: Toxicities of existing therapies for AAV need to be limited, with alternative methods and agents for induction and maintenance. Importantly, the side-effects of high dose and long-term steroids have now been recognized. Newer induction agents and maintenance regimes will lead the future of AAV treatment.

摘要

简介：ANCA相关性血管炎（AAV）是威胁生命的自身免疫疾病，需要诱导治疗和维持治疗相结合的治疗方法。传统上，大剂量糖皮质激素和环磷酰胺一直是AAV治疗的主要手段。在过去的十年中，利妥昔单抗已被证明是环磷酰胺的有效替代品。当前，正在进行关于诱导治疗和维持治疗的替代治疗选择的大量研究。

涵盖领域：AAV缓解，诱导和维持治疗的指南审查。审查有关替代性先进疗法的最新研究，特别是利妥昔单抗，C5a抑制剂和甲氧苄氨嘧啶-磺胺甲恶唑的证据。

专家意见：需要限制现有疗法对AAV的毒性，并采用其他方法和药物进行诱导和维持。重要的是，现已认识到高剂量和长期使用类固醇的副作用。更新的诱导剂和维持机制将引领AAV治疗的未来。