Therapeutic advances in the treatment of vasculitis.
Considerable therapeutic advances for the treatment of vasculitis of the young have been made in the past 10 years, including the development of outcome measures that facilitate clinical trial design. Notably, these include: a recognition that some patients with Kawasaki Disease require corticosteroids as primary treatment combined with IVIG; implementation of rare disease trial design for polyarteritis nodosa to deliver the first randomised controlled trial for children; first clinical trials involving children for anti-neutrophil cytoplasmic antibody (ANCA) vasculitis; and identification of monogenic forms of vasculitis that provide an understanding of pathogenesis, thus facilitating more targeted treatment. Robust randomised controlled trials for Henoch Schönlein Purpura nephritis and Takayasu arteritis are needed; there is also an over-arching need for trials examining new agents that facilitate corticosteroid sparing, of particular importance in the paediatric population since glucocorticoid toxicity is a major concern.
ARUK centre for Paediatric and Adolescent Rheumatology, Institute of Child Health and Great Ormond St Hospital NHS Foundation Trust, 30 Guilford Street, London, WC1N 1EH, UK. d.eleftheriou@ucl.ac.uk.
Despina
D
Eleftheriou
Department of Paediatric Rheumatology, Institute of Child Health and Great Ormond St Hospital NHS Foundation Trust, 30 Guilford Street, London, WC1 E1N, UK.
Paul A
PA
Brogan
D002648:Child; D004359:Drug Therapy, Combination / Q000379:methods; D005938:Glucocorticoids / Q000494:pharmacology*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000494:pharmacology*; D007155:Immunologic Factors / Q000494:pharmacology; D054539:Medication Therapy Management; D014657:Vasculitis / Q000145:classification / Q000175:diagnosis / Q000628:therapy
D005938:Glucocorticoids; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors