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The traditional treatment of systemic vasculitides with long-term oral cyclophosphamide (CPM) and high-dose corticosteroids has given way to more conservative approaches with shorter induction with CPM, followed by maintenance treatment with azathioprine or methotrexate.1 Despite this, 30–50% of patients relapse by 12 months. Endothelial dysfunction and tumour necrosis factor (TNF) α play a major part in pathogenesis.2 Raised TNF levels are associated with vascular damage and correlate with disease activity.
We describe an open-label uncontrolled prospective study of anti-TNFα (infliximab), in the management of patients with systemic vasculitides who failed to maintain remission on conventional immunosuppressive treatment.
We prospectively …