Randomized controlled trials in vasculitis associated with anti-neutrophil cytoplasmic antibodies.
OBJECTIVE
To review three major randomized clinical trials in forms of vasculitis associated with anti-neutrophil cytoplasmic antibodies.


RESULTS
The design features, results, and context of the Cyclophosphamide versus Azathioprine for the Remission Phase of Vasculitis, Non-renal AAV alternatively treated with Methotrexate, and Wegener Granulomatosis Etanercept Trial are reviewed.


CONCLUSIONS
Until recently, therapies for Wegener granulomatosis and microscopic polyangiitis have been based primarily on a relatively small number of nonrandomized studies. During the past 18 months, three randomized, controlled trials (one double-blinded) have been performed in vasculitis associated with anti-neutrophil cytoplasmic antibodies. Careful comparisons of the results of these trials yield insights into new standards of care for vasculitis associated with anti-neutrophil cytoplasmic antibodies. This paper summarizes the designs of these three trials; highlights their principal conclusions, strengths, and shortcomings; and distills from their results several recommendations on major questions related to the therapy of vasculitis associated with anti-neutrophil cytoplasmic antibodies.
Goek
Oemer N
ON
The University of Heidelberg.
Stone
John H
JH
D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood*; D001379:Azathioprine / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000627:therapeutic use; D000068800:Etanercept; D014890:Granulomatosis with Polyangiitis / Q000188:drug therapy* / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008727:Methotrexate / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D016896:Treatment Outcome
D019268:Antibodies, Antineutrophil Cytoplasmic; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D018124:Receptors, Tumor Necrosis Factor; D003520:Cyclophosphamide; D001379:Azathioprine; D000068800:Etanercept; D008727:Methotrexate