title: [Development of morbidity and mortality in ANCA-associated vasculitis].
abstract: The outcome of ANCA (antineutrophil cytoplasmic antibody)-associated vasculitis (AAV) has been significantly improved due to the combined use of cyclophosphamide (CYC) and glucocorticosteroids. Recent studies demonstrated a normalization of life expectancy for several subgroups of AAV patients. Mortality is highest in the first year after diagnosis and infections are the most frequent cause of death. Older age and renal failure are associated with worse outcome. The use of Pneumocystis jiroveci prophylaxis and subsequent activity-adapted GC dose reduction (target: below 10 mg per day) can substantially reduce the risk of severe infections. Late sequelae of CYC medication, such as cystitis and malignancy should be recognized and can be minimized by the usage of uroprotection with mesna and avoidance of high cumulative CYC doses.
authors.affiliation: Klinik für Rheumatologie und klinische Immunologie Klinikum Bad Bramstedt und Poliklinik für Rheumatologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland. reinhold-keller@rheuma-spezialisten.de
authors.forename: E
authors.initials: E
authors.lastname: Reinhold-Keller
authors.forename: F
authors.initials: F
authors.lastname: Moosig
mesh_terms: D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality*; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000401:mortality / Q000517:prevention & control; D002423:Cause of Death; D015267:Churg-Strauss Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality; D003520:Cyclophosphamide / Q000009:adverse effects / Q000627:therapeutic use; D005938:Glucocorticoids / Q000009:adverse effects / Q000627:therapeutic use; D014890:Granulomatosis with Polyangiitis / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality; D006801:Humans; D009369:Neoplasms / Q000139:chemically induced / Q000401:mortality / Q000517:prevention & control; D009894:Opportunistic Infections / Q000401:mortality / Q000517:prevention & control; D012307:Risk Factors
chemical_list: D018501:Antirheumatic Agents; D005938:Glucocorticoids; D003520:Cyclophosphamide