The systemic vasculitides are rare autoimmune diseases with significant morbidity and mortality. These diseases have primarily been treated using glucocorticoids combined with other immunosuppressive medications. While successful for many patients, this strategy is associated with substantial adverse effects including glucocorticoid-related toxicity and infection. Recent clinical trials have identified glucocorticoid-sparing agents and alternative efficacious therapies. In this article, we discuss new developments in the treatment of giant cell arteritis and ANCA-associated vasculitis. Topics reviewed include the use of biologic agents for treating giant cell arteritis and polymyalgia rheumatica, as well as the use of plasma exchange and strategies to minimize glucocorticoid exposure in ANCA-associated vasculitis.

全身性血管炎是一种罕见的自身免疫性疾病，具有显着的发病率和死亡率。这些疾病主要使用糖皮质激素联合其他免疫抑制药物进行治疗。虽然对许多患者来说是成功的，但这种策略与包括糖皮质激素相关毒性和感染在内的大量不良反应有关。最近的临床试验已经确定了糖皮质激素节省剂和替代有效疗法。在本文中，我们讨论了巨细胞动脉炎和 ANCA 相关性血管炎治疗的新进展。审查的主题包括使用生物制剂治疗巨细胞动脉炎和风湿性多肌痛，以及血浆置换的使用和减少 ANCA 相关性血管炎中糖皮质激素暴露的策略。