[Treatment of systemic vasculitides].
The treatment of necrotizing vasculitides may be based on several drugs, depending on the disease itself, its severity, its etiology and the expected prognosis. In practice, the least severe forms, associated with a prognostic score of 0, may be treated with corticosteroids only, while the ones associated with severity factors should be treated with an association of corticosteroids and immunosuppressants. The first-line treatment of viral-associated vasculitides should be based on antiviral drugs. The treatment duration of non-infectious vasculitides is typically 18 to 24 months. The improvement in prognosis is due to the treatment as well as to anti-infectious prophylaxis and careful management of potential complications.
Service de médecine interne, centre de référence maladies rares vascularites et sclérodermies systémiques, hôpital Cochin, Université Paris-V-René-Descartes, Paris. loic.guillevin@cch.aphp.fr
Lïc
L
Guillevin
Christian
C
Pagnoux
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001379:Azathioprine / Q000008:administration & dosage / Q000627:therapeutic use; D015267:Churg-Strauss Syndrome / Q000188:drug therapy; D002986:Clinical Trials as Topic; D003449:Cryoglobulinemia / Q000188:drug therapy; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D000068800:Etanercept; D014890:Granulomatosis with Polyangiitis / Q000188:drug therapy; D006509:Hepatitis B / Q000150:complications / Q000188:drug therapy; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007372:Interferons / Q000008:administration & dosage / Q000627:therapeutic use; D010951:Plasma Exchange; D010488:Polyarteritis Nodosa / Q000188:drug therapy / Q000209:etiology; D011379:Prognosis; D011446:Prospective Studies; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D012008:Recurrence; D012254:Ribavirin / Q000008:administration & dosage / Q000627:therapeutic use; D012306:Risk; D012720:Severity of Illness Index; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D014657:Vasculitis / Q000145:classification / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D014777:Virus Diseases / Q000150:complications / Q000188:drug therapy
D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000998:Antiviral Agents; D007074:Immunoglobulin G; D016756:Immunoglobulins, Intravenous; D007166:Immunosuppressive Agents; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D012254:Ribavirin; D003520:Cyclophosphamide; D007372:Interferons; D001379:Azathioprine; D000068800:Etanercept