Background ANCA-associated vasculits (AAV) are a group of multi-system autoinmune diseases characterized by inflamation and necrosis in small and medium vessels.AAV could respond to diferent therapeutics protocols depends on diverse levels of clinical severity and early treatment could improve the outcome of the disease.In spite of recognized efficay of regimens consisting of cyclophosphamide and high-dose corticosteroids to control the AAV,efforts to minimize drugs-related toxicity led to consider targeted therapies.
Objectives Considering the currently quality evidence in therapies novely proposed to AAV and the severity of renal disease presentation,we suggest new rational approaches emphasizing targeting B-cells therapy and preventing disease relapse
Methods We identified the latest quality evidence using methodological search filters,assessed the evidence quality with Cochrane Renal Goup check list and determinated the strenght of recommendations by Levels of Evidence (Oxford Centre for Evidence-based Medicine)
Results Rituximab (RTX), a monoclonal anti-CD 20antibody, has emerged as the biologic agent more using in AAV patients in current publications and unlike latest Guides and Recommendations published,RTX would be recommended in induction and maintenance AAV with renal involvement treatment (Table 1).
Conclusions Current therapeutical protocols for AVV with renal involvement show that emerging therapies like RTX could improve rates of relapses and treatment-related toxicity. Further studies would provide target-therapeutical options
Vazquez V et al. Clinical practice guideline for ANCA-associated vasculitis with renal involvement. Medicina (Buenos Aires). 2015;75 Suppl 1:1–38
Mukhtyar C et al. EULAR recommendations for the management of primary small and medium vesselvasculitis. Ann Rheum Dis 2009;68:310–317.
Guillevin L et al. Rituximab versus Azathioprine for Maintenance in ANCA-Associated Vasculitis. N Engl J Med 2014;371:1771–80.
Disclosure of Interest None declared
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