[How to treat systemic necrotizing vasculitides?].
Corticosteroids and, according to severity or vasculitis type, cytotoxic agents are prescribed to treat systemic necrotizing vasculitides. Usually, in most vasculitides, treatment is prescribed for at least 18 months. Treatment is able to obtain a remission in approximatively 90% of patients. Relapse rate is high. Cyclophosphamide is usually prescribed for a few months, and administered by pulses. A maintenance treatment is compulsory and comprises usually azathioprine and methotrexate. Biologics can be proposed as ad on therapy like intravenous immunoglobulins and anti-TNF. Rituximab, an anti-CD20 drug is as effective as cyclophosphamide. It can be also prescribed to maintain remission.
AP-HP, hôpital Cochin, université Paris-Descartes, Sorbonne Paris Cité, service de médecine interne, Inserm 1016, 75014 Paris, France. loic.guillevin@cch.aphp.fr
Loïc
L
Guillevin
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage / Q000627:therapeutic use; D002755:Choice Behavior; D003520:Cyclophosphamide / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D010488:Polyarteritis Nodosa / Q000145:classification / Q000628:therapy*; D012074:Remission Induction; D000069283:Rituximab; D056647:Systemic Vasculitis / Q000145:classification / Q000628:therapy*
D000305:Adrenal Cortex Hormones; D058846:Antibodies, Monoclonal, Murine-Derived; D016756:Immunoglobulins, Intravenous; D007166:Immunosuppressive Agents; D000069283:Rituximab; D003520:Cyclophosphamide