Therapeutic strategies for systemic necrotizing vasculitides.
Treatments of vasculitides have progressed markedly over the past few decades. The first attempts to obtain better-adapted therapeutic strategies evaluated the indications of conventional drugs, and their abilities prolong survival and reduce the number of relapses, while decreasing the severity and number of side effects. Many prospective clinical trials were organized by the French Vasculitis Study Group and the European Vasculitis Study group, and have contributed to optimizing targeted treatment strategies. Recent therapeutic strategies include immunomodulating methods, like plasma exchanges, or products, like intravenous immunoglobulins, or, more recently, new agents called biotherapies. Some of them have achieved promising positive effects, for example, anti-CD20 monoclonal antibodies, and are now being evaluated in prospective trials.
Guillevin
Loïc
L
Department of Internal Medicine, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Université Paris-René-Descartes, Paris, France. loic.guillevin@wanadoo.fr
Pagnoux
Christian
C
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20 / Q000276:immunology; D000998:Antiviral Agents / Q000627:therapeutic use; D001808:Blood Vessels / Q000473:pathology; D015267:Churg-Strauss Syndrome / Q000276:immunology / Q000628:therapy; D003520:Cyclophosphamide / Q000627:therapeutic use; D000068800:Etanercept; D014890:Granulomatosis with Polyangiitis / Q000276:immunology / Q000628:therapy; D015658:HIV Infections / Q000150:complications; D006509:Hepatitis B / Q000150:complications; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007155:Immunologic Factors / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D000069285:Infliximab; D009336:Necrosis; D010951:Plasma Exchange; D010488:Polyarteritis Nodosa / Q000276:immunology / Q000628:therapy; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D000069283:Rituximab; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology; D014657:Vasculitis / Q000188:drug therapy / Q000276:immunology / Q000473:pathology / Q000628:therapy* / Q000821:virology
D000305:Adrenal Cortex Hormones; D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20; D000998:Antiviral Agents; D007074:Immunoglobulin G; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000069283:Rituximab; D003520:Cyclophosphamide; D000069285:Infliximab; D000068800:Etanercept