title: Progress in treatment of ANCA-associated vasculitis.
abstract: Autoantibodies to neutrophil cytoplasmic antigen-associated vasculitis (AAV) is characterised by inflammation of blood vessels. The introduction of immunosuppressive therapy with glucocorticoids and cyclophosphamide transformed AAV from a fatal condition to a largely treatable condition. Over the past 30 years, considerable progress has been made refining immunosuppressive regimens with a focus on minimising toxicity. There is, however, a high unmet need in the treatment of AAV. A proportion of patients are refractory to current therapies; 50% experience a relapse within 5 years and treatment toxicity contributes to mortality and chronic disability. As knowledge of the pathogenesis of vasculitis grows, it is mirrored by the availability of biological agents, which herald a revolution in the treatment of vasculitis. Lymphocyte-targeted and cytokine-targeted agents have been evaluated for the treatment of AAV and are entering the routine therapeutic arena with the potential to improve patient outcomes. As rare diseases, treatment advances in vasculitis depend on international collaborative research networks both to establish an evidence base for newer agents and to develop recommendations for patient management.
authors.affiliation: Department of Renal Medicine, Addenbrooke's Hospital, Hills Road, Cambridge CB20QQ, UK. ronasmith@doctors.net.uk
authors.forename: Rona M
authors.initials: RM
authors.lastname: Smith
authors.forename: Rachel B
authors.initials: RB
authors.lastname: Jones
authors.forename: David R W
authors.initials: DR
authors.lastname: Jayne
mesh_terms: D000818:Animals; D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D001688:Biological Products / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D001688:Biological Products; D007166:Immunosuppressive Agents