title: Refractory disease in antineutrophil cytoplasmic antibodies associated vasculitis.
abstract: OBJECTIVE
  Induction treatment of antineutrophil cytoplasmic antibodies (ANCA) associated vasculitis (AAV) is not always successful and nonresponding patients are considered refractory.
  
  
  RESULTS
  Refractory disease should be subdefined to the treatment that was received. Cyclophosphamide refractory AAV occurs in up to 5% of patients. Many more patients develop contraindications to cyclophosphamide or relapse frequently. The latter two patient groups might also benefit from treatment used for cyclophosphamide refractory AAV.
  
  
  CONCLUSIONS
  The most promising drug for treating refractory AAV is rituximab.
authors.affiliation: Department of Rheumatology and Clinical Immunology, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands.
authors.forename: Abraham
authors.initials: A
authors.lastname: Rutgers
authors.forename: Cees G M
authors.initials: CG
authors.lastname: Kallenberg
mesh_terms: D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000188:drug therapy* / Q000276:immunology; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000627:therapeutic use; D004351:Drug Resistance; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D000069283:Rituximab
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D000069283:Rituximab; D003520:Cyclophosphamide