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In the excellent study recently published in the Annals of the Rheumatic Diseases, F Moosig et al1 evaluated the individualised and more aggressive strategy of immunosuppressive treatment in 150 patients with EGPA. Over the last decade, we used the same approach in our cohort of 117 patients with EGPA. For induction of remission the authors used cyclophosphamide in patients with Five Factor Score (FFS) of 0 and with other organ-threatening or life-threatening manifestations, for example, active peripheral nervous system involvement, alveolar haemorrhage or severe eosinophilic alveolitis. FFS was developed in 1996 as a predictor of poor prognosis in patients with systemic vasculitides.2 It was revised in 2009.3 FFS was used in several trials performed by French Vasculitis Study Group as a guide to choosing …
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