Some major advances on the different systemic vasculitides during the past year will be analyzed.
A key point to improve the management of any systemic vasculitis is a deeper knowledge of the major pathogenetic events implicated. Genetic predisposition and antigenic stimulation of the immune system by exogenous triggers and/or autoantigens have been intensively investigated. In HCV-related cryoglobulinemic vasculitis the identification of a key infectious trigger, and the possible treatment with antiviral agents or immunosuppressors, proved useful to better dissect the role of treatments acting on upstream or downstream pathogenetic events. However, in this disease we learnt that it is the clinical picture, i.e., disease severity, the main discriminant for treatment decisions, at present.
There are different novel treatments proposed for different vasculitides, and major points include the the optimal induction therapy and treatment of refractory cases, the optimal maintenance regimen, and strategies for glucocorticoid sparing.
Laboratory and imaging examinations not only for the diagnosis, but also for the monitoring of the disease, and to better predict treatment response and the risk of relapse, are relevant.
Both the prompt diagnosis and the proper classification of the type of primary or secondary vasculitis are crucial, and criteria to facilitate both of them are then important.
Disclosure of Interest None declared