title: Indications for biotherapy in systemic vasculitides.
abstract: Biotherapy now holds a specific place in the therapeutic armamentarium for systemic vasculitides. Such therapy includes cytokines, such as (pegylated) alpha-interferon for hepatitis B virus-related polyarteritis nodosa and hepatitis C virus-related cryoglobulinemic vasculitis, and polyvalent immunoglobulin (IVIg), with well-defined indications and pending positive results. More specifically targeted monoclonal antibodies include antitumor necrosis factor-alpha or anti-CD20 for antineutrophil cytoplasmic antibody-associated vasculitides or anti-interleukin-5 and anti-IgE for Churg-Strauss syndrome. However, the exact indications of these latter new agents, as well as their optimal dosage and duration, are not defined. Therefore, they are prescribed mainly for patients with disease refractory to conventional therapy, in whom results are promising. Results of international ongoing trials will determine whether the agents may also have a place as first-line treatment.
authors.affiliation: Department of Internal Medicine, French Vasculitis Study Group, Centre de Référence Vascularites et Sclérodermie, Hôpital Cochin, Université Paris Descartes, Paris, France. loic.guillevin@cch.aphp.fr
authors.forename: Loïc
authors.initials: L
authors.lastname: Guillevin
authors.forename: Christian
authors.initials: C
authors.lastname: Pagnoux
authors.forename: Philippe
authors.initials: P
authors.lastname: Guilpain
authors.forename: Boris
authors.initials: B
authors.lastname: Bienvenu
authors.forename: Valérie
authors.initials: V
authors.lastname: Martinez
authors.forename: Luc
authors.initials: L
authors.lastname: Mouthon
mesh_terms: D019268:Antibodies, Antineutrophil Cytoplasmic / Q000276:immunology; D001691:Biological Therapy; D003449:Cryoglobulinemia / Q000150:complications / Q000473:pathology / Q000628:therapy / Q000821:virology; D006509:Hepatitis B / Q000150:complications / Q000473:pathology / Q000628:therapy / Q000821:virology; D006526:Hepatitis C / Q000150:complications / Q000473:pathology / Q000628:therapy / Q000821:virology; D006801:Humans; D014657:Vasculitis / Q000150:complications / Q000276:immunology* / Q000378:metabolism / Q000628:therapy*
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic